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Open Colostomy Reversal

AMBULATORY CARE:

What you need to know about open colostomy reversal:

Open colostomy reversal is done to reconnect your intestines and remove the stoma.

How to prepare for your surgery:

  • Follow the directions your healthcare provider gives you to prepare your bowels for surgery. You may be told to drink only clear liquids and to eat no solid foods for a few days before surgery. Clear liquids include water, broth, apple juice, or lemon-lime soft drinks. You may also suck on ice chips or eat gelatin. You may need to drink a special fluid or take medicine to empty your bowels the day before your surgery.
  • You may need to check into the hospital the night before your surgery. You may be given medicine or an enema to help empty your bowels.
  • If you are not admitted to the hospital, your healthcare provider will give instructions. You may be told not to eat or drink after midnight the night before your surgery. You will also be told what medicines to take or not take the morning of your surgery.

What will happen during your surgery:

  • You may get antibiotics before your surgery to help prevent an infection caused by bacteria. You may also get antibiotics during and after your surgery.
  • You will be given anesthesia to keep you asleep and pain-free during your surgery.
  • Your healthcare provider will make an incision in the middle of your abdomen and around your colostomy. He or she may cut along the same incision that was used when you received a colostomy. Your healthcare provider will cut away your stoma from the skin. He or she will reconnect the cut ends to the rest of your colon with staples or stitches.
  • Your healthcare provider may put 1 or 2 drains under the skin near your surgery area. These drains may help your surgery wound heal. The drains will be removed when your wound stops draining fluid. The cut in the middle of your abdomen will be stitched or stapled closed. The area where your stoma was may be stitched or stapled closed. The area may also be left open to heal. If it is left open, the area will be filled with gauze. Bandages will be placed on your surgical wounds to keep them dry and to help prevent infection.

What will happen after your surgery:

You will be monitored until you are fully awake. Then you will be taken to your hospital room. You may have a tube that goes into your nose, through to your stomach. This tube helps keep your stomach empty while your bowels start to work again after surgery. Your healthcare providers will help to walk the evening after surgery. When you walk, it helps your bowels to start working. It also helps prevent blood clots. You will be encouraged to walk several times daily while in the hospital.

Risks of open colostomy reversal:

  • You may bleed more than expected during or after your surgery. There is a chance your ureters, bladder, or bowels may be damaged during the surgery. You may get an infection. Your healthcare provider may not be able to reconnect your colon. If this happens, you will need to keep your colostomy. Your colon may leak or pull apart. Contents of your bowel can leak into your abdomen. This can cause a life-threatening infection.
  • Your intestines may become narrow or blocked after surgery. You could get a painful hernia, months or years after surgery. You may need another surgery to fix these problems. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. This can become life-threatening.

Call 911 if:

  • You suddenly feel lightheaded and short of breath.
  • You have chest pain when you take a deep breath or cough. You may cough up blood.

Seek care immediately if:

  • You have severe pain in your abdomen.
  • Your abdomen becomes swollen and hard.
  • Your vomit or bowel movements are black or have blood in them.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Contact your healthcare provider if:

  • You have a fever of 101ºF (38.3ºC) or higher.
  • You are not able to have a bowel movement for 3 days.
  • You have nausea or are vomiting.
  • Blood soaks through your bandage.
  • Your wound is red, warm, swollen, or draining pus.
  • You have questions or concerns about your condition or care.

Surgical wound and bandage care:

Check your surgical wound for signs of infection daily. Signs of infection include redness, swelling, foul smell, pain, and pus. Change your bandage if it gets wet or dirty and as directed by your healthcare provider.

Self-care:

  • Use adult incontinent briefs. As your bowel function gets back to normal, you may have accidents. Your bowel movements may be more liquid.
  • You may need a barrier cream to keep your anus from getting irritated from wiping. Clean your anus with warm water after each bowel movement. Reapply barrier cream after cleaning. Avoid baby wipes and powder. These can cause more irritation.
  • Do not lift more than 10 pounds for 4 weeks or as directed. Do not bend or twist. This will help your surgery area heal and decrease your risk for a hernia.
  • Do not drive until your healthcare provider says it is okay.

Do not smoke:

Nicotine and other chemicals in cigarettes and cigars can cause blood vessel damage. Blood vessel damage can keep your surgery from healing properly. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Nutrition after surgery:

  • Do not eat late at night. You may have bowel movements through the night. Your digestive system needs time to work properly.
  • Eat a variety of high-fiber foods to prevent constipation. High-fiber foods include cooked beans, fruits, vegetables, and some cereals. Ask your healthcare provider how much fiber you should have.
  • Avoid or limit foods that can irritate your digestive system. These foods include spicy and fatty foods, and citrus fruits, such as lemons and oranges. Also avoid foods that cause gas, such as broccoli, cabbage, and cauliflower. Beans, eggs, and fish may also cause gas. Limit alcohol and carbonated drinks, such as soda.
  • Drink liquids as directed to prevent constipation. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.
  • Exercise regularly. Exercise helps move bowel movements through your colon. It also helps prevent blood clots. Ask your healthcare provider about the best exercise plan for you.

Follow up with your surgeon as directed:

You may need more tests to make sure your colon is healing properly. Write down your questions so you remember to ask them during 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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