This topic is about someone considering a colostomy reversal after having their Crohn’s disease in remission for 18 months. They had a sigmoid colostomy in March 2016 due to Crohn’s disease and IBS. Now, they are contemplating whether to undergo a reversal to restore normal bowel function, provided it doesn’t lead to the same issues they faced before surgery, like spending excessive time in the bathroom and affecting their work and family life. They are seeking advice and insights on whether to proceed with the reversal or keep the stoma.

Here are some helpful points to consider:

1. Weigh quality-of-life trade-offs:
- Some people choose to keep their permanent stomas because they fear the return of pre-surgery symptoms like incontinence, pain, and bathroom urgency, which might eventually require more surgery.
- Others find that having an ileostomy or colostomy offers them more freedom for travel, work, and daily activities compared to life before surgery.

2. Consider age and general health:
- Age and health can influence the decision. For example, someone was advised at 36 that they were too young for a permanent bag and opted for a J-pouch, which they are still happy with at 56. However, they would now choose to keep a bag if the pouch failed.
- Another person was denied a J-pouch at 57 due to higher complication risks and later felt relieved to have avoided multiple corrective surgeries.

3. Understand the risks of a J-pouch or reversal:
- Complications such as leakage, night-time incontinence, and chronic infections can occur, and outcomes can vary widely.
- It’s important to ask your surgeon to explain all the risks and long-term success statistics to make an informed decision.

4. Gather patient-to-patient experience:
- Online forums and Facebook groups have extensive discussions about reversals, successes, and failures, which can help set realistic expectations.

5. Importance of an expert surgical team:
- Outcomes with J-pouches and ostomies are better when performed by experienced, specialized surgeons and supported by knowledgeable stoma nurses.

6. Lifestyle with a permanent ostomy can be highly active:
- Many people with ostomies report enjoying activities like swimming, ocean and lake outings, maintaining normal sex lives, and being able to change pouches discreetly with minimal supplies.
- Keeping spare appliance kits handy can reduce bathroom dependency while traveling.

7. Emotional and social factors:
- Some people worry about dating with an ostomy, but long-term partners often adapt well. Peer support communities can help build confidence.
- Take your time to process the decision, involve your family, and ask all the questions you have. People in ostomy forums are ready to share practical tips.