Colostomy Reversal

The main reasons a temporary stoma may be formed are for bowel cancer, inflammatory bowel disease, diverticulitis and injuries to the bowel that mean it has to be rested, so that it may heal.

Improved surgical techniques mean that operations to form permanent stomas are declining. However, for more than 65% of ostomates, their stoma is permanent.

For those whose stoma can be reversed, the outcome will depend on how much and which part of the bowel was removed. If very little rectum remains, then it is likely that bowel control will be impaired.
 
Before making a decision about reversal it is best to:
  • Ask the consultant or nurse specialist for detailed information regarding the proposed surgery and the realistic outcome in terms of hospital stay, recovery time and expected bowel function both in the short-term and long-term.
  • Speak to others who have undergone a similar procedure - The Colostomy Association have specially trained volunteers who have undergone the reversal procedure.  
There are two types of colostomy, an end colostomy or a loop colostomy, the features of each are summarised in the table below :
 
End Colostomy Features Loop Colostomy
Usually on the left hand side of the abdomen Site Also usually on the left, but may be on the right, above the umbilicus
One stoma on the abdominal wall. Occasionally, there may be a completely separate stoma in addition called a 'mucous fistula' Appearance One stoma on the abdominal wall, but with two holes, so it tends to be slightly bigger in overall diameter than an end stoma.

This one hole produces faeces into a stoma bag.

If there is a second stoma present, (mucous fistula) it produces only mucus.

Stoma Function One hole produces faeces, the other is basically redundant, but there may be overflow of faeces into this hole, and then down into the distal bowel and out through the anus.
The reversibility of an end colostomy often depends on where the other end of the bowel is! Potential for Reversal A loop colostomy is designed as a temporary solution in most cases, and most of these are technically reversible.
An end colostomy can only be reversed by finding the other end, and successfully joining them together. This may involve more complex surgery than that required to make the stoma initially. Ease of Reversal A loop colostomy can usually be reversed by just cutting round the stoma and stitching the two holes back together, without opening the abdomen, and is considered to be minor surgery.
 

For further information, please download the Colostomy Association leaflet "About Stoma Reversal" hereor contact us to receive a copy by post.

A Successful Reversal - Read Lisa's story

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