Is it possible to get rid of an ostomy bag? (Ostomy Reversal) Let's talk about the surgery

Do you have a pouch attached to your abdomen to drain your waste? You may have had a colostomy or ileostomy as a treatment for a bowel disorder or condition. You probably know the discomfort of living with this pouch. So, the question that many people have is, "Can't I just put it back the way it was?" It really can be done. That's what we're talking about today.

What is Ostomy Reversal?

Simply put, an ostomy reversal is a surgery that removes the pouch in your abdomen and restores your bowel function. You may recall that during your first surgery, the doctors made a hole in your abdomen where part of your intestine (colon or ileum) came out through the skin. We call it a stoma . The stool came out through that stoma.

Now, in this reversal surgery, the intestine that was connected to the stoma is brought back into the abdomen and reconnected with the rest of the intestine. Then, the hole in the abdomen (stoma) is closed. After this, you will be able to defecate through the anus again in the old way.

Why do so many people want to have this surgery?

This is something that is really up to you. Many people choose this because they want to go to the toilet again in their old, normal way. This surgery is like a chance to go back to the life they had before having the ostomy bag fitted.

After this surgery, you no longer have to worry about changing your ostomy bag or keeping the skin around your stoma clean. Sometimes, living with things like leaking from the bag and skin allergies can be very stressful. So this surgery is a great relief to be free from all those burdens.

How do I qualify for this surgery?

If you want to have this surgery, your doctor will take a few things into consideration. Not everyone can have this surgery. It depends on your health. Usually, this surgery is considered after about 3 to 12 months.

See the table below for the main qualifications required for this.

What tests are done before surgery?

Your doctor may perform several tests to see if you are suitable for surgery, such as:

• Endoscopy: A tube with a camera is inserted through the anus to check for diseases or blockages inside the intestines.
• Contrast X-ray: A special liquid (contrast fluid) is given and an X-ray is performed to see if there is a leak anywhere in the intestine.
• Digital Rectal Examination: The doctor uses his finger to examine the muscles of the rectum.
• Blood tests: Blood tests are done to find out about your nutritional status and other health problems.

What happens during the surgery?

You will be given general anesthesia, so you will not feel anything during the surgery, you will be asleep. The doctor will usually follow these steps:

1. The part of the intestine (stoma) that is attached to the skin of the abdomen is removed and separated.

2. That section is then reconnected to the lower part of the intestine. This is called an anastomosis in medical terms.

3. Finally, all surgical wounds, including the stoma hole in the abdomen, are sutured closed.

What are the risks and side effects that may occur after surgery?

Like any surgery, there are some risks involved. Infection, bleeding, and blood clots can occur.

But there is a very serious risk that is specific to this surgery. That is a condition called anastomotic leak . That is, a leak from the place where the two intestines are connected. This can be a little dangerous, because bacteria from the intestines can enter the abdominal cavity and cause an infection. If you have symptoms like fever and severe pain in the lower abdomen, you should suspect it. But this happens very rarely.

Short-term side effects

The following are common in the early days after surgery:

• Pain and discomfort: Surgical wounds may cause mild pain and discomfort, similar to a full stomach.
• Paralytic Ileus: It is normal for the bowels to be a little sluggish for a few days after surgery. This is why liquid foods are given first.
• Changes in bowel habits: When the bowels start working again, you may experience diarrhea at first. Some people may also experience constipation. It is also normal to need to go to the bathroom more often. These will improve after a few months.

Long-term side effects

• Hernia: A part of the intestine protrudes through the skin through a surgical incision.
• Abdominal Adhesions: Adhesion of tissues inside the abdomen due to surgery.
• Fecal incontinence: Some people may have difficulty controlling their bowels due to weak rectal muscles. This can be treated with physical therapy.

How long does it take to recover? How should I take care of my diet?

It usually takes about 6 to 8 weeks to fully recover. During this time, you will gradually regain your strength.

You need to be especially careful about your food and drink.

• Start with easy-to-digest, low-fiber foods (e.g. bananas, rice, bread).
• Drink plenty of water , especially if you are constipated.
• Stop drinking alcohol, carbonated drinks (like soda), and coffee for a while.
• Instead of three big meals, eat several small meals a day.
• Identify which foods cause you discomfort and avoid them for a while.

What are the symptoms that require you to see a doctor immediately?

You will be given follow-up days after the surgery. However, if you experience any of the symptoms below, see your doctor immediately.

• If the pain and swelling are getting worse
• If there is nausea and vomiting
• If you have a fever
• If there is pus-like fluid coming from the surgical wound
• If diarrhea or constipation persists
• If you have difficulty keeping food or liquids down

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