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May 29, 2011

Recovery Time After Reversal and Issues to Expect

The topic is about understanding the recovery time and potential issues one might face after having an ileostomy or colostomy reversal. This is a procedure where the stoma is closed, and the bowel is reconnected, allowing for normal bowel function. Here are some insights and advice shared by others who have gone through this experience:

1. Hospital Stay: Typically, you might expect to stay in the hospital for about 3 to 5 days. For example, one person was admitted on April 7 and went home on April 11.

2. Initial Bowel Function:
- It's common to have very frequent bowel movements, around 10 to 15 times a day, for the first few weeks or months.
- Many people find that their bowel movements become more predictable within 3 to 10 months, though some may take up to a year.

3. Skin Care: To soothe a sore bottom, using baby wipes and a zinc-oxide cream like Sudocrem can help relieve irritation.

4. Managing Output:
- Taking Metamucil (psyllium) daily has helped some people thicken their stools.
- Loperamide (Imodium) is often used to control the frequency of bowel movements, with the dose adjusted as needed.
- One person tried Selba tablets but did not find them helpful.

5. Diet Tips:
- Foods like tomato-based dishes, spicy sauces, and high-fat meals can cause urgency for some people.
- It's a good idea to gradually reintroduce foods and keep a diary to track any that cause gas or pain.

6. Continence Aids: During the adjustment period, wearing pads or light diapers is common, and accidents tend to decrease over time.

7. Complications to Watch For:
- Be alert for rectal or anal bleeding and seek medical attention promptly.
- Watch for pain, bloating, or obstruction at the surgery site, which, though rare, can be serious.
- An incisional or parastomal hernia might occur; using a hernia support belt during activities can help prevent this.
- The risk of re-rupture is higher if the original disease involved radiation damage.
- The risk of infection or C-diff increases with age or repeated antibiotic use.

8. Timing Considerations:
- Many surgeons suggest waiting at least 6 to 12 months after the original surgery or any major complication to allow tissues to heal fully.
- One person was advised that leaving a loop ileostomy for more than about 12 months could weaken the rectal sphincter, making reversal more difficult.

9. Age and General Health: Successful reversals have been reported in people aged 18, 72, and in their mid-70s. Being in good overall health can aid recovery.

10. Emotional Aspect: Most people felt that regaining "normal" toilet use was worth the discomfort, though a few opted for a permanent ostomy because their quality of life was already high or due to potential complications.
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