This topic is about considering whether an 82-year-old woman should undergo an ileostomy reversal. After having an emergency ileostomy, she has adapted well to her current situation but is not fond of the appliance. The family is weighing the potential benefits and risks of a reversal, especially given her age and some minor health issues. They are seeking real-world experiences to help decide if the reversal would improve her quality of life or possibly make it worse.

Here are some helpful insights and advice:

1. Understand the underlying condition and remaining anatomy:
- If the ileostomy was due to ulcerative colitis and most of the colon was removed, loose and frequent stools might continue after reversal.
- It's important to ask the surgeon how much of the colon remains and what type of reconstruction is planned, whether it's a straight anastomosis or a J-pouch.

2. Evaluate anal-sphincter strength:
- Long-term use of an ostomy can weaken the anal muscles. Doing daily Kegel exercises during the ostomy period can help reduce the risk of accidents after reversal, especially at night.

3. Be aware of potential outcomes with a J-pouch or straight reconnection:
- Some people experience severe pain, frequent bowel movements, and butt-burn, and may eventually return to an ileostomy.
- Creating a J-pouch involves removing more of the small bowel, which can lead to a B-12 deficiency requiring lifelong injections.

4. Consider age-related factors:
- As people age, they naturally lose some sphincter control, heal more slowly, and face higher risks with surgery and anesthesia.
- Each additional abdominal surgery increases the chances of adhesions, infections, and hernias.

5. Compare current life with potential post-reversal life:
- Many people manage an ileostomy comfortably, with wear-time up to a week, discreet emptying, and full participation in work, travel, and social activities.
- Reversal often involves a long recovery, and the early weeks can bring urgency, incontinence, or constipation. No surgeon can guarantee the outcome.

6. Practical decision-making tips:
- Focus on the patient's own preferences and abilities. If she is coping well now, surgery might not offer much benefit.
- If managing the pouch becomes difficult, online communities can provide tips on preventing leaks, extending wear time, and using accessories.