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Nov 08, 2016

Key Questions for Discussing Colostomy and Ileostomy Reversal

This topic is about preparing for a colostomy-to-ileostomy reversal and final reconnection after cancer treatment. The person involved has completed chemotherapy and radiation, and their recent medical tests suggest that a reconnection might be possible. Here are some key points and advice to consider:

1. Prepare a detailed list of questions for your surgeon. Important topics include the length of your remaining colon and rectum, the risk of continence issues if the rectal valve or nerves were affected, the chances of chronic diarrhea, and the timeline for a potential ileostomy reversal.

2. Be aware that after losing some colon length, you might experience looser or more frequent stools due to reduced water re-absorption. Long-term use of anti-diarrheal medications, whether prescription or over-the-counter, is common and usually manageable.

3. Radiation can have lasting effects on bowel tissue, so ask your doctor how previous radiation treatments might impact healing, bowel movement, and the risk of leakage.

4. If you haven't experienced neuropathy from chemotherapy, consider consulting a registered dietitian. They can provide dietary advice that might help prevent or reduce neuropathy.

5. After reconnection, walking early and often can help restore bowel function and reduce bloating. Be prepared for "butt burn," a common irritation in the rectum that usually resolves within a few weeks. Taking fiber supplements like Metamucil twice daily can help thicken stools and regulate their frequency.

6. Keep an eye on the risk of hernia at the former stoma site, as surgical repair might be necessary after reversal.

7. A balanced diet is crucial for healing and can help normalize stool consistency.

8. Continence outcomes can vary, so discuss potential pelvic-floor therapy options with your healthcare provider in case you experience control issues.
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