This topic is about understanding the long-term concerns and potential complications for someone living with a colostomy, especially when considering whether to undergo a reversal surgery. The person sharing their experience is one year post-surgery and is seeking advice on what to expect in the next 10 to 20 years. They are particularly interested in the following:

- How often issues like fissures, parastomal hernias, or significant stoma shrinkage occur, which might require relocating the stoma.
- The chances of needing diapers due to leakage as they age.
- Skin problems around the stoma as the skin becomes thinner with age.
- The number of times a stoma can be safely relocated.
- Comparing the long-term complication rates of a permanent colostomy with the risks associated with reversal surgery, such as organ injury, scar tissue buildup, insufficient colon length, loss of rectum, new leaks, and anesthesia risks.

In a follow-up, they express additional concerns about reconstruction:

1. Each surgery carries the risk of damaging nearby organs.
2. Scar tissue can complicate future surgeries.
3. Uncertainty about how often a stoma can be safely moved.
4. Concerns about whether the remaining colon can still reach the abdominal wall after previous surgeries.
5. Fear of waking up with a new ostomy if the surgical plan changes during the operation.
6. The possibility of needing an internal pouch due to an inadequate rectum.
7. The risk of developing new leaks after further surgery.
8. The risks associated with general anesthesia during another major operation.

Here are some insights and advice shared by others:

- Parastomal hernias are a common long-term issue. Some people have developed them, with one person needing mesh repair but still managing well. A stoma is technically a created hernia, and some individuals are more prone to hernias than others.
- To prevent and manage hernias, regular, gentle abdominal-core exercises are recommended, as they may help reduce the risk. Avoid heavy lifting, or use a hernia/support belt when lifting. One person wished they had known about belts before handling heavy suitcases. If a large hernia develops, stoma relocation and mesh reinforcement might be attempted, but repairs can fail again with straining, even from a sneeze.
- Stoma relocation is possible, but options decrease with each move and as scar tissue increases.
- Skin issues around the stoma, such as minor sores or irritation, can occur but are manageable. With experience, most people learn which products and care routines work best for them.
- No one reported needing diapers solely due to having a long-term colostomy.
- Regarding reversal, one person with a colostomy for six years was advised that waiting longer could improve the odds of a successful reversal. Another person, who is older, chose to keep their ostomy because the risks of a second surgery and recovery seemed too high.
- A resource was shared: the "Hernias and Exercise" page on Stoma Data, which explains exercises and protective measures for those with ostomies.