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What is an Ileostomy Takedown?

By Erin J. Hill
Updated Mar 03, 2024
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An ileostomy takedown is a procedure in which an ileostomy is reversed. The initial procedure involves taking the end of the small intestine and disconnecting it from the large intestine, or colon. It is then routed to an opening in the abdomen called a stoma. When it is taken down, the large intestine is either reconnected to the colon or to an ileoanal reservoir, which is often constructed from tissue taken from the small intestine.

Patients may undergo this procedure if the colon has recovered from a procedure and can function properly again, or if the colon has been removed entirely. If the colon is still in place, the large and small intestines are reconnected and digestive function resumes as normal. If not, when the colon has been removed, a pouch is constructed and routed to the anus. This allows feces to exit the body as normal, but without the use of the colon.

Those who have an ileostomy takedown with the use of an ileoanal reservoir may have to defecate up to 12 times per day in the beginning. The feces may appear very watery and patients may have trouble controlling their bowels. Disposable undergarments may help with hygiene issues. Over time, the internal pouch expands and is able to hold more fecal matter at once. Additionally, the anal muscles regain strength and it becomes easier to control bowel movements.

Once recovery from the ileostomy takedown is complete, patients may only need to move their bowels three or so times per day. The consistency becomes less watery as the small intestines adjust to absorbing more water during digestion. Since the colon generally reabsorbs water from waste matter, those who do not have one may find it difficult to stay hydrated. These individuals may be advised to drink additional fluids and to consume more sodium because it causes the body to retain water.

When the small intestines are rerouted to the anus, the opening in the abdomen, or stoma, can be sutured shut. Patients should allow several days for this area to heal entirely. They may have to visit the doctor to have sutures removed, which usually takes place at the first follow-up visit.

Following an ileostomy takedown, patients may be advised to avoid certain foods to reduce the risk of digestive upset. They will also need to take note of which foods cause issues like constipation and diarrhea and limit their consumption. Patients should be given information on dehydration symptoms so they know when there is a problem in order to receive medical attention.

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Discussion Comments
By Monika — On Jun 06, 2012

A friend of mine is in medical school, and she recently did her surgical rotation. She got to witness an ileostomy reversal, and she said it was pretty interesting. The digestive system is really amazing in that it can still function, even if entire parts of it (like the colon) are missing.

My friend also told me that people have a difficult time with ileostomy related surgeries psychologically. It can be embarrassing to have to run to the bathroom a bunch of times a day or deal with "accidents."

By SZapper — On Jun 05, 2012

@KaBoom - I had an older relative that had an ileostomy and then an ileostomy takedown. He had colon removal done too, so he had to deal with that also. The recovery did take awhile, but luckily he was retired so he didn't have to deal with work.

The article is right about the potential for becoming dehydrated without your colon. You definitely have to pay very close attention to how much water you're drinking and up your sodium intake. Follow-up visits to the doctor are also recommended, just to make sure you're not getting too dehydrated.

By KaBoom — On Jun 04, 2012

Wow, this sounds like a really involved medical procedure! Not only do you have to have a few surgeries, you have to factor in recovery time, which sounds like it would be a lot.

I can't imagine trying to recover from ileostomy takedown surgery and needing to go to the bathroom 12 times a day. I'm assuming people that have this procedure done have to take time off from work, because there is no way you could hold down a job in that kind of condition.

But it sounds like most people eventually go back to a more normal bathroom schedule and can return to their normal activities, so I guess that's good.

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