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Jun 08, 2013

Successful Ostomy Reversal - Progress, Hope, and Life After Surgery

The topic is about life after an ostomy reversal, focusing on early successes, common challenges, and practical tips for those going through this transition. Here's a breakdown of helpful advice and insights:

1. Early Recovery and Expectations
- Adjusting to a "new normal" is common, with bowel movements ranging from 4 to 10 times a day initially. Accidents may occur for several months but often improve significantly by 3 to 6 months and continue to get better over a year.
- The body gradually adapts, with urgency and nighttime accidents decreasing if meals are finished early and caffeine or late snacks are avoided.

2. Managing Stool Frequency, Liquidity, and Accidents
- Soluble fiber and bulking agents like Metamucil, psyllium, All-Bran cereal, and fiber gummies or bars can help. Aim for 25-35 grams per day, but introduce them slowly to prevent gas.
- Some typical regimens include taking Metamucil capsules before meals and at bedtime or a teaspoon in water at night for those sensitive to larger doses.
- Medications like Imodium, Lomotil, and tincture of opium can help slow down bowel movements, while Miralax or stool softeners are used when stools are too hard.
- Probiotics, digestive enzymes, and L-glutamine powder are mentioned for gut comfort and tissue healing.

3. Protecting Skin, Hemorrhoids, and "Butt-Burn"
- Calmoseptine ointment is recommended for relief from acid burn and hemorrhoids.
- Desenex cream and custom "cotton-ball cheetos" can reduce chafing.
- Sitz baths and careful wiping are helpful, and acidity tends to decrease as the diet stabilizes.

4. Stoma-Site Care After Takedown
- There are two closure methods: stitched shut or left open to granulate. Open sites may drain fluid for 6-9 weeks, and using a non-scented pad with a spandex waist-cincher can help keep gauze in place.
- Expect gradual healing, but contact a doctor if there is foul-smelling or bloody drainage.

5. Surgical Techniques and Pre-Op Questions
- Re-anastomosis can be done with a circular stapler or hand-sewn sutures. Discuss the possibility of temporary strictures, hernia risks, and pain management options with your surgeon.

6. Pelvic-Floor and Sphincter Strengthening
- Exercises from Dr. Anderson on Ostomy.org are recommended. Initial soreness is normal, but improvements can happen quickly.

7. Diet and Lifestyle Tips
- Eat small, fiber-balanced meals and avoid carbonated drinks, beer, large salads, or high-fat meals until you understand your body's new patterns.
- Carry spare underwear or Depends early on and plan outings for late morning after a light breakfast.
- Travel is possible, with some people reporting successful international trips once routines are established.

8. Emotional and Practical Support
- Sharing success stories is important, as many people leave forums once they are "bag-free." Positive posts can provide hope.
- Accept setbacks like hernia repairs or infections as temporary challenges, not failures.
- A good colorectal specialist and allowing the stoma to mature for 9-12 months before reversal can improve outcomes.
See full discusison
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