Pre-Op Concerns for End Ostomy Reversal

Long story short, on March 27th I'm having an endostomy takedown. I was under the impression that I would have to drink a bowel prep or start antibiotics before the surgery. However, when I asked the doctor's nurse about this, he told me that I did not have to have any of that before the operation, just follow the instructions on the pre-op sheet, like nothing after midnight, etc. Has anybody had this done? Can you enlighten me on why I would not have to have that done to clean my intestines so no stool leaks out while he's reconnecting? Or am I just freaking out for no reason? I have anxieties, this isn't helping. I need help, please. It would help a great deal.

Hi Chuck,

Well... I'm no colorectal surgeon, but I'd assume no matter how squeaky clean they get your bowels, there will always be residual stuff in them, so there will always be the risk of having bad stuff in your colon no matter what. But more than likely when they go to reconnect, they'll give you an IV motility drug to stop your peristalsis dead in its tracks, so nothing's moving in there anyway. Plus, they'll fully pinch off the bowel and the rectum, clean both areas real well... and then sew you back together with the clamps in place.

Last time I had a resection, I woke up with a stomach pump stuffed up my nose and down my throat that kept anything from leaving my stomach and entering my bowels... and that stayed in for 3 days to give the bowel a chance to heal. Not sure if they still do that anymore... or if they found a better way to join bowel sections. If it were me, I'd call the surgeon's staff... they're usually not very busy anyway... and ask. I'm surprised the surgeon didn't explain the operation details with you when he saw you. There are no stupid questions when it's your body being diced and sliced. He really won't mind the question.

;O)

Did they tell you to follow an all-clear liquid diet the day before surgery and to have nothing after midnight?

I had an ileostomy reversal and no prep the day before. Just nothing after midnight. I could drink sips of water for a while because the surgery ended up being in the afternoon.

I'll be having my reversal (colostomy) March 30, and I will have to do a prep the day before, no antibiotics though.

Really? Before anything has been done with my intestines, it has always been clear liquids the day before and nothing after midnight. I wonder if it depends on the doctor.

I don't know if it's because I don't have a colon? Oh, you know what, I just remembered they did the test for leaks in my new connection the day before the surgery. I didn't have to do any of the regular protocol because of the no colon. I feel like I was able to eat that day after, but my appetite hasn't been great. So if they told me no food after a certain time, I probably wouldn't have thought twice. I'm trying to think of someone who I would've talked to or been around that day who might remember, lol. I think my husband took me, but all Drs appts/procedures/surgeries blend together for him. He pretty much asks if I'm awake/ok and if I tried to punch anyone coming out of anesthesia, lol.
I do remember thinking maybe I shouldn't have eaten whatever I ate before the surgery because that was when I got really sick with the ileus.

My personal experience is prep not required.

Over the years, I have had quite a few patients complain to me that I didn't prepare them for what take-down surgery would be like.

Diarrhea and flaming acid because you are going to have dumping syndrome. You do not have the bacteria in that part of your gut anymore to digest foods. So your natural acid will come flying out. Invest in a 3 lb jar of petroleum jelly and be patient. Don't plan on life immediately thereafter until your body becomes reaccustomed to having an anus that works. That is in addition to recovering from major abdominal surgery. Be patient with yourself.

I tell all of my patients, whether they're having gut surgery or their appendix out or a broken kneecap, it doesn't matter, it takes about 1 year to recover once you've passed a 30-year-old mark. Mark your calendar and begin life again slowly.

I'd be lying if I didn't say I'm slightly jealous. I really wanted a reconnect, but the disease portion of my bowel extended down my sigmoid to my anus and no treatment in the world made it better. After three solid months in the hospital the first time around, I finally gave up on the idea, but I'm really happy for those of you who have the opportunity.

It sounds like an end colostomy is being closed. There is a difference in prep between closing an ileostomy and colostomy referencing Crappy's comment. When a colostomy is closed, the complications including the anastomosis leak rate is significantly reduced with a bowel prep of laxatives and antibiotics. Sometimes it is referred to as a Nichols prep. The pre-surgery preparation is nothing more than a colonoscopy bowel prep plus antibiotics. Which antibiotics that are used may vary, especially since neomycin is difficult to obtain recently. Everyone has pre-op anxieties which go away post-op. How you do post-op will depend upon how low the anastomosis is located in your rectum. Ultra-low anastomosis can have a "low anterior syndrome" which temporarily causes small frequent stools because you have lost storage capacity and your remaining rectum is irritable. Higher anastomosis have fewer problems. Good luck!

Oh great, you're calling me crappy now too. I blame Bob.

They usually remove your large intestines and connect your small to your anus. It takes about 6 months to a year to get right. They are working on an artificial anus and other ways of reconnecting. That's why I'm waiting. Everyone I know has to still wear depends in case of accidents. You will go 15 times a day until you learn how to hold it and eat right.

How did your reversal go? Did you have any post-op complications?

So far, okay, I think. None other than what is to be expected, I believe.