Is Ostomy Reversal Painful and Risky?

Is reversal of an ostomy painful? A surgeon told me, "If it ain't broken, don't fix it." He said there are too many possible complications and it is extremely painful, with incontinence on and off!

Is he right?

Junebug

Hello June

No more painful than your other surgery. I don't know where "extremely painful" comes from; however, complications cover a great array of issues. It really is a crap shoot.

Do you have any colon left? I think that is a huge factor in reversal success. Mine is gone, and my surgeon encouraged a j-pouch. Truthfully, my reversal surgery itself was my least painful one. It was my life with a j-pouch after that surgery that was crummy and led me to a permanent ostomy.

I have heard there are a lot of possible complications to a reversal. I can't have one because I don't have enough large intestines left over to connect to. But I have heard that it is a complicated surgery and that there can be infection and all sorts of problems involved.

When I had my ostomy surgery, the plan was to have it reversed in 3 months. Six months later, I finally got OR time! This surgery was much less invasive, painful, and had way less recovery time. My recovery was much faster. However, using my colon/bum to poop afterwards was a long trek. Totally worth it, but wear a disposable undergarment! I'd say it depends on whether you have enough rectum to have the reversal. Based on your individual circumstances and doctor recommendations, you should then make an informed decision. I'm about a year and a half post-reversal, and I still can poop up to 6 times a day. Just be prepared (get a bidet and a portable bidet for your time outside the home) to wipe a lot.

My Ostomy Journey: Bruce | Hollister

A couple of years ago, I was given the choice to hook my colon back up. I asked the surgeon, "If I do, will you assure me I will not mess my pants while in line at Costco?" He replied, "No, I cannot tell you that." Great, I live with Poncho by my side; it's never failed me.

Hi June, you can find all the pros and cons on YouTube videos. Just type in what you need in the search bar and presto.

Yes, it was painful but well worth it. The first 4 to 5 weeks, I wasn't sure I did the right thing, but 8 weeks in, everything is working well. I would get a second opinion if you can. Good luck!

Hi...

I had an ostomy for about 1 year. I was not happy about having one and chose to have a reversal on April 1st...April Fools' Day...

I had the typical post-surgery pain for a few days that was controlled by meds...and after that with Tylenol.

I was in the hospital post-surgery for about 5 days or so, then sent home. Diet was as you would think...very much liquid/jello in the hospital, but once I had a couple of bowel movements, I was told to eat what I wanted but be smart about it. (No suicide wings for a while...)

I had a bit of 'staining' from my rectum...hadn't used it for a year...but now 4 1/2 months post-reversal, everything is pretty much good. No incontinence. They gave me exercises to do pre-reversal (and post) called 'anal winks' that helped strengthen the anal muscles up a bit.

So...for me...no painful issues and/or complications.

Maybe I was lucky...I don't know.

My surgeon here in Orillia, Ontario was the best. Which may have had a great deal to do with it.

Good luck to you. It was the best decision I could have made for me.

Reversing an ostomy and hooking everything back up can have complications, even with an excellent surgeon.
The things that might become a problem are leaking at the site where the intestine was sewn back together. This can cause peritonitis (severe widespread infection of the abdominal cavity) and sepsis (blood poisoning).
Also, some surgeons want to let the previous ostomy site heal with the skin layer open to avoid infection.
It requires wound care and could take 4-6 weeks for it to close up. It depends on the doctor, so you would ask whoever would be doing the operation.
The saying "leave well enough alone" has some merit.

If the colostomy reversal occurs very low in the colon where the two ends of the intestine are sewn back together, near the rectum, your bowel may not work as predictably as it did before, sometimes for several months up to a year.

A way to make a colostomy more manageable if you decide to keep it is to see if you are a candidate for colostomy irrigation. It used to be taught to the majority of colostomy patients, but not as much now. It's very safe.
This cleans out the colon, either daily or every other day. Usually, there is little or no output or need to empty the pouch once the irrigation is completed.
A colostomy nurse can show you how it's done. It definitely makes life more manageable. Plenty of online and YouTube info about this procedure.

I had an emergency colostomy in April 2023, after which I was advised it was reversible. One of the lucky ones.

Reversal was carried out on July 2nd this year, finally inclusive of hernia removal.

I was always warned of possible complications with the reversal; however, I decided to go ahead with it in conjunction with the hernia. My biggest apprehension was the potential to require a temporary ileostomy; however, this was an unknown and, to my relief, was not required.

Due to the hernia, I was advised that the reversal operation would be a bigger op.

Generally, I found the pain from the original colostomy and reversal very similar. Recovery, I feel, has been a little slower; however, I am starting to get a bit more energy. Just over 6 weeks since the reversal, final dressings removed, and the scar from the stoma is pretty minor and I feel it could disappear completely. I was advised originally that recovery would be around 10 weeks (a little longer than the original op), but I feel I am getting there. Looking forward to life changes following the last 2 years, and I feel it has all been worth it.

Best of luck whatever your decision.

Doug

I think it really depends on a lot of things. I had an emergency colostomy due to a perforated colon. I had a Hartmann's procedure to remove my sigmoid colon, and the ER doc who did it said I could have it reversed in three months. The surgeon who was doing the reversal said he wouldn't do it for at least nine months to allow for healing and the best possible outcome. I think he was right. I had my reversal about seven weeks ago, and all went super well. Definitely not as much pain as the first surgery to create the ostomy, but I was also sick then with an infection that caused the need for it. I was in the hospital for the reversal for three nights, and that was with open surgery - 28 staples! I had my first bowel movement six days later. It wasn't all that painful. The abdominal staples were more painful than going to the bathroom, but even they weren't that bad. The first few days I was pooping maybe 9-10 times per day, but I didn't have a lot of the urgency I'd read about. Now, it's almost back to pre-times, maybe 2-3 times a day and no pain. I am definitely still healing because it doesn't feel exactly as it did before, but I'm getting there. My stoma hole was made into three smaller ones with staples in between, and they packed them with gauze, which they removed before I left the hospital. I had to keep the whole thing covered for almost four weeks, and by then the holes were closed. I'm really glad I went through with the reversal - I was scared, but my doc told me 85% chance it'd all go well, and for me it did. But everyone is different, so find a surgeon that will give it to you straight based on your specific situation.

I'm 64 and had emergency surgery on November 1st due to a macro tear in my colon. I'd never had any stomach issues before this happened. I was quite weak, became malnourished, and was in the hospital for 2 weeks. The recovery was difficult due to being so malnourished. I had it reversed on March 17th (figured the luck of the Irish!) and it went well. My original surgeon was out of the Cleveland Clinic, Dr. Trunzo, and I am forever grateful to him and all the amazing nurses at the clinic who took care of me. My second surgery was at Kaiser in Honolulu. I was concerned about having it in Hawaii, but I had Kaiser and it was not an emergency, so I had to have it done there. Dr. Sawai did a good job. It was 4.5 months after the first surgery, and I did fine. So far, no issues. I do physical therapy for pelvic floor, and the therapist also does massage to break up scar tissue, which can cause pain later. I spoke to several people who'd had the reversal, and they all told me they did fine, so for me, knowing the rest of my colon was okay, I went for it. I'm pooping once or twice a day and am still very careful about core exercises and not lifting more than 15 pounds at this point. I do not want an incisional hernia. I would go get a second opinion with a doctor who will go over more details of your particular case. I researched a lot of doctors before my reversal and wanted to make sure I had complete faith in my doctor. You can find a lot of info here and on YouTube, which is where I learned most things about how to manage my ostomy when I had one. Best of health to you. You may also have a support group in your area where you can meet and talk with other ostomates. Ask your stoma nurse about that.

I had a successful reversal! I just have a hilly roadmap off a belly.
I had colon left, so the surgery was worth it.

No surgery comes with a guarantee of no complications. Surgery and post-care are not painful. My bum is sore like the dickens for a few weeks. Maybe 1 day out of 14, I feel like running a bit more, but I usually can tell.

I had a colostomy takedown, and it didn't seal properly, so my surgeon had to give me an ileostomy. When I was in the hospital for the ileostomy takedown, a predicted 4-day stay turned into 16 days because my plumbing wouldn't work properly. Neither of those surgeries was anywhere near as bad as my initial hospital stay for a perforated colon. All that being said, I wouldn't trade being hooked back up for anything.

May I ask why you had one in the first place? Just wondering if it was colitis. Wondering why so many poops during the day. Was this the way it was prior to surgery? Thinking about getting a reversal as I have diversion colitis, and the only cure is a reversal if meds don't work. But I'm kind of nervous to have it reversed. The surgeon isn't really wanting to do it because of complications.

You can live with a hernia; I have a very large one. Drink 1 gallon of liquid a day and move your belly around.

Hi June Bug:

I'm 6 months post-colostomy takedown. I had my colostomy for 4 months; in October of 2024, I had emergency surgery for a bowel perforation that happened during a colonoscopy (my GI doc found inflamed diverticula and an abscess in the sigmoid colon, and it perforated when he tried to go past it. I also had a huge number of adhesions on the outside of the sigmoid colon, attaching it to the small bowel! They had to remove all the diseased tissue and about 3 inches of my sigmoid colon. The colostomy was placed high up on the descending colon, above my waist. All of that was done with robotic laparoscopic surgery.) While I had my colostomy, I had horrible reactions to the adhesive and plastic of the wafer against my skin (I am terribly allergic to both.) My surgeon moved up my reversal date to 4 months instead of 6 due to my bleeding angry rash. He did the reversal in February, again using robotic laparoscopic surgery. I had 6 little incisions, and the stoma "hole" was repaired with a spiraling suture, so I now have a 2nd belly button when it closed up on itself, LOL. I was so relieved to have the reversal surgery!!! My poor skin still has a scar from the ostomy wafer adhesive.

The reversal surgery ended up being more painful and took longer to heal due to the number of incisions and the reconstruction he had to do. One incision on my right hip took longer to heal due to a deep suture...he said that's where the stapler went in (on the robotic arm.) I was picturing a big office stapler; no wonder it hurt! Anyway, they had to insert that on the right side to then put the permanent titanium staples on my left side to reconnect the two parts of the colon. I now expect to set off the metal detectors at airports.🙂 I had a LOT of abdominal core/pelvic floor PT after my reversal surgery, and that helped. The pain level was minimal after about 8 weeks.

Bowel function post-reversal has been a gradual process. My gastroenterologist said it would take about a year after reversal to get back to normal. I wanted to be able to get back to foods that have fiber and tried many, but I've found that they still cause a lot of gas and discomfort. I can have salad, but only about twice a week. At first, right after the reversal, I had crazy frequent (small) bowel movements - for about 2 weeks, then it calmed down. Now, after 6 months, I'm back to my normal main one every morning and one smaller one in the evening (which is new.) I think the transit time of my shorter sigmoid colon is gradually getting the hang of it. My surgeon said that the shorter sigmoid colon now goes directly to the rectum in a straight line instead of a right angle bend and is stretched and narrower. Over time, it will dilate further. So, I just have to be patient. I'm seeing my gastroenterologist in a couple of weeks for a 6-month check, and we'll discuss diet and such then.

Summary: SO GLAD I had the reversal, and I hope I never have to have an ostomy again. My colon is now a little smaller and operates a little differently, but my skin is healing and I'm much healthier overall.

Pain is relative, and there is always a risk of complications when surgery changes your body. I had my reversal on December 9, 2024 (9 months and 9 days after emergency surgery for a perforated sigmoid colon). It was via robotic surgery with a fantastic general surgeon in Stockton.

The worst part of the surgery was the nursing care in the hospital afterward. I was expecting to be there for 5 days, but after 3, I asked my surgeon to discharge me because I didn't feel safe with the care.

I had no complications with the reconnection part of the surgery. A week after the reversal, I did have to go back to the surgeon to fix cellulitis (wound infection). Nursing care was better that time, and I left with a wound vac.

Overall, the pain was minimal (usually 5-6 and no more than a 7-8 at any time). The only time I needed pain meds was during wound changes (I had a home nurse come in twice a week). I have extremely sensitive skin, and the adhesive was painful on my skin.

About a month after the reversal, my surgeon and I talked about the two hernias I got. One midline near the belly button was caused by the first surgery, and another at the stoma site (the bigger of the two).

My surgeon suggested living with them if they caused no problems. By the end of February, they caused discomfort and limited my activity.

I finally had the double hernia reversal on July 17, so I think that makes me 7 weeks post-op. The surgeon sutured the hernias internally and placed a large (one-piece) biological mesh over both repairs. I am overweight, and he promised to reinforce things for me.

The hernia repair surgery was 1000 times more painful than any surgery before (my surgeon warned me). I mean, pain like I never thought possible. The first 4 days were rough. I kept telling myself it was temporary.

Today I have discomfort where the stoma hernia was. I think it is because I developed a deep and large seroma. There were also a lot of tacks holding the mesh in place. If it continues past 12 weeks, I will get a CT scan to make sure the repair held. Hernia recurrence is common.

Would I do the reversal again? In a heartbeat. There was no way I was going to live with a colostomy for the rest of my life. I was prepared for much worse.

I am generally in good health and turning 58 in a couple of weeks. The younger and healthier you are, the easier the reversal.

Your surgeon also makes a difference. Don't settle for anyone. Find one you connect with, who listens to your concerns, and thoroughly answers your questions. If you are in the Stockton, CA area, I have the best surgeon ever! I traveled from out of town just to have him do the reversal.

Let me know if you have questions.