Considering Stoma Reversal After Latest CT Results

So, my latest CT shows no recurrence of cancer, but it also says this: “Stable additional findings including left lower quadrant colostomy with parastomal hernia and multiple fat and bowel-containing midline ventral hernias,” which sounds like my stoma is indeed the mess that I thought it was. Leaning more and more toward reversal.

What part, and how much of your colon was removed?

You know, I've never been told how much was cut, but I know I have enough of my rectum left to attach to; they checked that out. I think it was just the portion of my large intestine that was scarred by the previous radiation that sealed itself shut, so just the part next to my bladder. I was initially told the colostomy was temporary, then the cancer diagnosis changed that, as I wouldn't be able to do both chemo and reversal surgery—too much strain on the body (and mind!). Now I have two doctors telling me that it's possible, going to a third colo-rectal surgeon on 4/9 for her opinion. The multiple hernias are probably what is causing me grief, in addition to having a severely retracted and stenotic stoma giving my skin such a hard time.

Thanks for your reply.  

It's important to discover exactly how much sigmoid colon remains.  Length will impact "quality of life" after reversal surgery. 

First:  What functions does the sigmoid colon perform?

(A)  Stores fecal material until it is ready to be expelled. Its S-shaped structure allows it to hold a significant amount of waste without causing discomfort.  

(B)  Absorption: Although most absorption occurs in the small intestine, the sigmoid colon continues to absorb water, electrolytes, and some vitamins from the fecal material.  

(C) Formation of Feces: The sigmoid colon helps to solidify the fecal material by absorbing water and concentrating it.  

(D) Peristalsis: The muscular walls of the sigmoid colon contract rhythmically, propelling the fecal material towards the rectum.  

(E) Control of Defecation: The sigmoid colon plays a role in controlling defecation. When it is full, it sends signals to the brain that it is time to have a bowel movement. The sigmoid colon can also hold the fecal material for several hours, allowing for convenient timing for bowel movements.  

Other Functions:  
The sigmoid colon helps to produce short-chain fatty acids, which are beneficial for gut health.  
It contains a population of beneficial bacteria that help to digest food and protect against infection. 

The average length of a sigmoid colon is 16 inches. 

As you can see, the sigmoid colon is vital for the formation of stool and predictable bowel  movements.

I have a colostomy.  Over 12 inches of my sigmoid colon was removed during surgery, leaving approximately 4 inches left.  

I have a mild parastomal hernia.

I was offered reversal, but I refused.  I don't have enough sigmoid colon remaining.  The output I see in my bag will pretty much be what exits my anus after reversal: soft, pasty, and sometimes watery.  There's not enough colon left to store and compact it, meaning increased trips to the bathroom.  And possibly I would struggle with bowel movement control.

Could be I'm wrong, and reversal would turn out fine.  But the physical odds are against me.

My gastroenterologist was willing to perform reversal, but not hernia repair.  The gastro surgeon would complete reversal, then a general surgeon would take over for hernia repair.

Read your surgical report.  

Ask lots of questions about hernia repair, mesh repair type, and post-surgical infection risk.

Good luck.

The body is amazing... all those functions done automatically.

My Ostomy Journey: Jearlean | Hollister

It is amazing. Most folks never give organs in the body any thought... until something goes wrong.

Researching the sigmoid colon was so interesting. This little section of colon, like other sections of colon, performs its own unique vital functions, especially bowel movement control. Without it, our daily lives would be quite different.

Our bodies are truly works of living art.

Thanks, I will look, and I will ask.

Hello Dwild. My whole sigmoid was removed due to a perforation during a botched biopsy. I had a colostomy for 8 months and had a parastomal hernia. My parastomal hernia was fixed during reversal, and it has been smooth sailing for me as far as function returning, which happened quickly with no issues. I know this is not always the case, but I wanted to share because some people do have good outcomes. Best of luck to you in your decision!

Thank you!