This topic is about preparing for an ileostomy reversal when only a small portion of the colon, about 12 cm, remains. The person involved is concerned about the risks of diversion proctitis, a condition that can occur when the colon is not used for a while, and is seeking advice on future surgical options.

Here are some insights and advice shared by others:

1. The person has 12 cm of colon left, with the rectum and anus intact, and is curious if the ileum (part of the small intestine) can adapt to absorb more water over time.

2. They wish to avoid further surgeries but are also concerned about the quality of ostomy bags provided by insurance if an ileostomy becomes permanent.

3. There is limited information available on ileorectal anastomosis (IRA) compared to J-pouch procedures, so finding patient examples might be challenging.

4. The length of the remaining rectum is important. One person with 8 inches of rectum attached to the ileum experienced diversion proctitis, which improved after a colectomy. They have a backup plan for an end ileostomy if proctitis returns.

5. Another person with a 6-inch rectal stump never reconnected due to unmanageable proctitis and developed Crohn’s disease in the stump, leading to a permanent end ileostomy.

6. Surgeons and members advise against reconnecting if there is active proctitis, as inflammation present before reversal is likely to continue afterward. If proctitis cannot be controlled long-term, a proctectomy or permanent ileostomy might be necessary.

7. Regarding water absorption, both surgeons and members note that the small intestine does not absorb water as effectively as the colon, so expect looser output after an IRA.

8. If returning to a bag becomes necessary, modern ostomy care can make long-term management feasible. It's important to be psychologically prepared and to secure reliable, high-quality pouching supplies.

9. The community encourages taking time to consider all scenarios, staying informed, and keeping others updated on progress.