Bowel (colorectal) cancer: stoma reversal operation

Surgery to reverse a temporary colostomy or ileostomy (reconnection of the bowel) can be is a relatively minor procedure, but not all colostomies or ileostomies can be reversed. Deciding when to do the reversal depends on a number of factors including how well the patient has healed after their initial surgery and how fully they have recovered from other treatments like chemotherapy or radiotherapy. Sometimes reversals can be done after a matter of weeks (usually 12 weeks after surgery) while in other cases it takes much longer –sometimes up to several years.

After surgery, patients stay in hospital until their bowel begins to function again. This may happen after a few days but can take longer.

Once the bowel has started working again many people experience problems with constipation or diarrhoea and face what may be a long process of restoring their eating and bowel habits. Occasionally, complications such as adhesions (a build-up of scar tissue) mean that the reversal operation proves impossible and the stoma must become permanent.

Everyone who discussed their reversal operation had looked forward to it because it meant they would be free of their stoma. One man said he “couldn’t wait to get into hospital” and came out “smiling like a basket of chips”. Even people who were anxious at the thought of further surgery looked forward to having their colostomy or ileostomy reversed.

Several people were surprised and disappointed at how long it took for their bowel to start functioning again after surgery. One man was expecting a hospital stay of 2 or 3 days but found that it was 10 days before he could be discharged. Another man waited half that time but still considered it to be “an eternity”.

Many people had difficulty with their eating and bowel habits after their reversal operations. Some began to experience chronic constipation or diarrhoea. Reintroducing foods gradually over time on a trial and error basis was the usual way forward, though for some problems persisted. One man describes the terrible attacks of diarrhoea he suffered when his bowel began to work again:

Describes the attacks of diarrhoea he experienced after his ileostomy was reversed.

Age at interview 70

Gender Male

Age at diagnosis 68

View profile

It was one of the things that wasn’t explained in great detail to me, how horrendous I think is the word, things could be. It wasn’t explained that you would get vicious attacks of diarrhoea, at fairly frequent intervals it was, to start off with it was sort of every six or seven days, I’d get this violent attack of diarrhoea and I would go to the toilet probably ten, fifteen, twenty times in, in the day or usually during the night.

And my tail end was decidedly sore, couldn’t sit, couldn’t lie on my back, it was, it was very painful. But it was over and done with and then I was alright for the next few days.

How long, how long did this period of adjustment last?

This period of adjustment, lasted probably something in the region of about six to nine months. And what was happening was that the incidence of these occurrences got further and further apart, and the severity got less and less.

Embed Print Transcript

Several people had suffered complications that meant that their stomas could not be reversed. One man describes his initial reaction when his reversal proved impossible, and explains how he quickly came to accept the situation. A sympathetic visit from his surgeon after the failed operation helped him immensely.

Describes his initial disappointment at finding his colostomy could not be reversed and his…

Age at interview 65

Gender Male

Age at diagnosis 64

View profile

I’d said “Well fuck it”, you know! I did, I, I, I expected to be reversed but it hasn’t happened. You know, what was going through my mind, I was just disappointed that I couldn’t be normal again as I was.

And I wasn’t going up in the air, or shouting and screaming or anything like that, I was just very silent and very, very not upset even, just, disappointed. I think that’s the word, very, very disappointed. It’s like not passing an exam. That’s the type of feeling you know, and nothing worse than that. And the following day I just realised how lucky I was, really. And yeah, just get on with it.

So you know, basically, no I’m quite happy now, I must say and for anybody that goes through this situation, all I can say to them is that it’s not the best but it’s the best of, better than the other thing, right. So…

The other thing being?

Death! So, you know, that’s what it is, isn’t it? So, you know, what’s better? Better to walk about with a stoma aren’t you?

Embed Print Transcript

A sympathetic visit from his surgeon helped him after the attempt to reverse his colostomy failed.

Age at interview 65

Gender Male

Age at diagnosis 64

View profile

He came up after his rugby uh, match and he had his rugby shirt on and a raincoat and he sat with me and he said, “I’m so sorry,” he said “Did you hear what I said?” I said “Yeah, I did hear what you said.”

So he says, “I’m gonna sit with you for a while and discuss things with you.” And he asked me how I felt, and I said “I’m very, very disappointed.” He says “Well, I knew you would be, that’s why I’ve come to see you because in the, when I saw you before the operation, you were so elated about having an operation.”

And did it help you that hed come to see you like that?

Yes, very, very much so. I didn’t expect it, because I know hes a busy guy, and even if hes got time off he deserves it.

No, I didn’t expect, I expected to see him on the Monday or Tuesday you know, when they do pop in to see you. But I didn’t expect him to come and sit with me and he also rang my other half, to tell her what had happened, and I thought that was very kind. Yeah, he was, he was very good, very good.

You listen to them and as they’re talking somehow, that’s like therapy. It is. Not all of them have got that bedside manner but uh, he wasn’t too bad you know, he seemed to get the argument over and realised that he was getting to me, and I think that’s why he stayed with me so long.

He realised that what he was saying was doing me good. And when he went a lot stayed in my mind and he said “You’re healthy,” he says, “You’re fine, you’ll heal up and you’ll be OK.”

Embed Print Transcript

For more on restoring eating and bowel habits see Eating and bowel habit after bowel cancer surgery.