What is an Ileostomy Reversal?

An ileostomy reversal is a surgery performed to reconnect a section of small intestine to the large intestine, allowing a patient to evacuate feces through the anus instead of an artificial opening created in the abdomen. This procedure, as the name implies, reverses an ileostomy, a surgery where a section of small bowel is detached and used to create an opening through the abdomen for the drainage of feces, leaving the large bowel in place. Recovery time after the surgery varies, with several days in the hospital and weeks to months of adjustment at home.

Ileostomies are performed when the large bowel is so damaged that a patient is experiencing health problems. In some cases, allowing the large bowel to rest by temporarily diverting feces with an ileostomy is enough to address the inflammation and other damage, and the small bowel can be reconnected to the large bowel in an ileostomy reversal procedure once the patient has recovered. Patients may be alerted to this option when they discuss the initial ileostomy, with a caveat that complications may arise and make it impossible to reverse the original procedure.

Before the reversal can be performed, screening tests will be used to confirm that a patient is a good candidate for the procedure and to check for any complications and signs of concern. If everything looks good, the surgeon will schedule the procedure. While the patient is under general anesthesia, the surgeon will take the disconnected segment of small bowel and reconnect it to the large bowel. For several days, the patient will be monitored while recovering in a hospital setting. The patient may experience irregular bowel movements while the bowels recover.

At home after an ileostomy reversal, it is common for patients to experience bowel urgency and the need to defecate several times a day. This can occur for weeks or months while the bowel recovers from the surgery and the patient adjusts. Some patients may choose to wear pads or liners in their underwear in case of accidents, as it is common to have poor bowel control shortly after the procedure. Some patients recover control quickly and others may experience chronic problems. There is no way to predict how a patient's body will respond to the procedure and patients may want to consider talking with other people who have had ileostomy reversal surgeries to learn more about the range of symptoms they can expect.