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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.