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Ileostomy Reversal

AMBULATORY CARE:

What you need to know about ileostomy reversal:

An ileostomy reversal, or closure, is surgery to close your temporary ileostomy. Your healthcare provider will reattach your ileum to your colon. He or she will also close your stoma.

How to prepare for ileostomy reversal:

  • You may need an enema before your surgery. The enema has a contrast liquid in it that shows up on an x-ray. Your healthcare provider will check for leaking contrast liquid in your colon. He or she may also check your anal sphincter to make sure it is working properly. Ask your healthcare provider for more information about these and other tests you may need.
  • The day before surgery, your healthcare provider will tell you to only have clear liquids.
  • Your healthcare provider will tell you not to eat or drink for 8 hours before your surgery.
  • He or she will tell you what medicines to take or not to take the morning of your surgery.

What will happen during the surgery:

  • You will be given anesthesia to keep you asleep and pain-free during the surgery.
  • Your healthcare provider will make an incision around your stoma. He or she will bring the ends of your ileum and colon out of your abdomen. Your healthcare provider will connect them with stitches or staples. He or she may inject salt water to check for leaks.
  • Your healthcare provider will place your reattached intestines back into your abdomen through the incision. He or she will close the opening on your abdomen with stitches. Your healthcare provider may place a drain under your skin to remove extra fluid. He or she may also leave part or all of your skin open to heal on its own. Your wound may be covered with a bandage.

What happens after your surgery:

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. You will have to stay in the hospital until your bowels begin to function properly.

Risks of ileostomy reversal:

  • You may bleed more than expected. You may get an infection. You may become dehydrated.
  • You may bleed from where your ileum is stitched or stapled. After surgery, bowel contents may leak into your abdomen and cause an infection. You may also get an infection or abscess where your stoma was closed. You may have narrowing in your intestine that makes it difficult to have a bowel movement. Your intestines may also stop working for a short time after the surgery.
  • A fistula (abnormal tissue opening) may form between your intestines and a nearby organ. You may get a blood clot in your leg or arm. This may become life-threatening.

Call 911 if:

  • You cough up blood or feel lightheaded, short of breath, and have chest pain.

Seek care immediately if:

  • Your abdomen is swollen and hard.
  • You have blood in your bowel movement, or it looks black.
  • You have abdominal pain and you are vomiting.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Contact your surgeon if:

  • You have a fever of 101ºF (38.3ºC) or more.
  • You have not had a bowel movement for 2 days.
  • You are not passing gas.
  • You have abdominal pain that is not relieved by pain medicine.
  • Your surgery site is red, warm, swollen, or has pus coming from it.
  • You have symptoms of dehydration, such as dizziness, headache, dry mouth and skin, or increased thirst.
  • You have trouble urinating.
  • You have questions or concerns about your condition or care.

Medicine:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

After surgery self-care:

  • Do not lift more than 10 pounds for 6 weeks or as directed. Also, avoid bending, twisting, and intense exercise. This will help your surgery area heal.
  • Prevent blood clots and pneumonia. Walk around inside your house at least every 2 hours.
  • Check your surgery site daily. Check for signs of infection, such as redness, swelling, or pus.
  • Do not drive until your healthcare provider says it is okay.

Bowel care after surgery:

You may have more bowel movements than normal for the first weeks after surgery. You may no be able to tell if you need to pass gas or have a bowel movement. You may feel like you do not empty your bowels completely. This is normal. Your lower intestines have not been used in a while. Your healthcare provider may have you speak with a dietitian. You may also need to do any of the following to help your symptoms:

  • Eat 5 to 6 small meals per day. Chew your food well. Take your time to eat.
  • Change your diet. If you are having several bowel movements in a day, you may need a bland diet. You may need to eat white rice, bananas, and apple sauce. Avoid spicy and greasy foods. You may need to avoid dairy foods, such as milk and cheese.

Surgery site care:

Your healthcare provider will tell you how to take care of your surgery site. Keep your bandage clean and dry. Change your bandage if it gets wet or dirty. Ask your healthcare provider when you are able to shower. Do not soak in a bathtub, swimming pool, or hot tub until your healthcare provider says it is okay.

Follow up with your surgeon as directed:

You may need more tests. Write down your questions so you remember to ask them at your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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