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Jan 26, 2014

Is 5 months post ileostomy too soon for a reversal?

This topic is about the timing concerns of scheduling an ileostomy reversal surgery. The person sharing their experience is currently 3½ months post-surgery and is feeling uneasy about their surgeon's suggestion to have the reversal at 5 months, instead of the initially advised 6 months. They are seeking advice from others who have gone through or are considering a reversal.

Here are some insights and advice shared by others:

- If you feel rushed, take your time. It's important to have a thorough discussion with your surgeon about the pros and cons. You can postpone the surgery if you need more time to feel psychologically ready.

- Consider getting a second opinion from a highly experienced colorectal surgeon or a major medical center before making a decision.

- Ensure that your sphincter function and pelvic-floor integrity are strong. Tests like anorectal manometry, a defecating proctogram, and pelvic-floor therapy can help assess or improve your readiness for reversal.

- Personal experiences with reversal vary widely:
1. One person had a J-pouch reversal 5 months after surgery at age 60 and returned to normal in 2 weeks, but later needed a permanent ostomy due to precancerous cells.
2. Another person was cleared for reversal 6 months after a colostomy and is now completely back to normal.
3. A 29-year-old had a reversal just under 5 months post-op and, after a challenging first week, is now active and working without issues.
4. Someone else, 10 months post-reversal, still faces challenges with accidents and diet restrictions, using probiotics, digestive enzymes, Metamucil, and Imodium to manage symptoms, along with pelvic-floor yoga.

- Factors that might lead to poorer outcomes include significant loss of the rectum, prior radiation, infections, weak sphincter muscles, being overweight, and slow healing.

- If you experience pain during medical tests, such as a barium enema or proctogram, insist on stopping or modifying the procedure. Excessive pressure can lead to bleeding and prolonged discomfort.

- Some products and aids that might be helpful include Imodium, Metamucil, probiotics, digestive enzymes, glycerin suppositories, and an NG tube for managing obstructions.
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