This topic is about a person named Paul who is considering a surgical procedure called ileorectal anastomosis (IRA) after having a sub-total colectomy, which resulted in a stoma. Paul has also developed several hernias and a condition called diastasis recti. A new surgeon has suggested two surgeries to help with these issues. Paul is looking for advice and experiences from others who have undergone similar procedures.

Here are some helpful insights and advice for anyone in a similar situation:

1. Understand the reason for your original colectomy, whether it was due to diverticular disease, inflammatory bowel disease (IBD), cancer, or another condition. This can affect whether an IRA is a suitable option and how successful it might be in the long run.

2. Before deciding on an IRA, it's important to have thorough testing done on your rectum, anal canal, and sphincter muscles. Tests like flexible sigmoidoscopy, anorectal manometry, and endo-anal ultrasound can help determine if these areas are healthy and capable of handling the changes that come with an IRA.

3. People who have already had an IRA suggest making sure you meet the necessary functional criteria before proceeding. Without proper testing, there is a risk of complications or the reconnection not working as intended.