This topic is about a 59-year-old nurse who has been living with Crohn’s disease and has had a colostomy for the past three years. She is considering a colostomy reversal but is facing concerns from her doctors, employer, and family about the potential risks. She is seeking advice on whether to proceed with the reversal or not.

Here are some helpful insights and advice:

1. Ask for hard data before deciding:
- Request specific probabilities of success versus relapse from the surgeon willing to perform the reversal. Understand the risks involved.

2. Understand that the underlying disease usually remains:
- Reversal will not cure Crohn’s disease. Symptoms may return because the diseased bowel is still present.

3. Be aware that additional surgeries carry their own risks:
- More surgeries can lead to increased scar tissue and adhesions. Consider the potential for doubled recovery time and more pain.

4. Compare quality of life:
- Many people with permanent ostomies report fulfilling lives with minimal inconvenience. Consider if current challenges are worse than repeated hospitalizations.

5. Give yourself time to adapt:
- Consider postponing the surgery date and living with the mindset that the pouch is permanent for 6–12 months to see if acceptance grows.

6. Consider the pain and recovery realities:
- Those who declined reversal describe previous recoveries as extremely painful and lengthy.

7. Address continence questions:
- If considering reversal, ensure you have assurances about postoperative continence, as life could be more challenging without it.

8. Explore medication options for Crohn’s:
- Consult a gastroenterologist about biologics like Humira or Stelara, which may induce remission and reduce the need for reversal.

9. Seek emotional support and perspective:
- Many view the stoma positively, as something that saved their life. Engage with forums and experienced ostomates for support.

10. Conduct a final self-check:
- Consider if your dissatisfaction is psychological or due to malfunction. Ensure you have support for another recovery if reversal fails. Evaluate what aspects of pouch life outweigh the surgical risks.