Most colostomies are meant to be temporary, but the high risk of complications like leakage and infection can keep many people from having the procedure reversed.
You might need a colostomy to help you recover after a traumatic injury or to treat a disease such as colorectal cancer. If so, how long will you need it?
While some colostomies are required permanently, others might only be needed temporarily after a surgical procedure or while you recover.
We look at if and when your colostomy might be reversed, what happens during reversal surgery, and possible complications.
A colostomy reversal surgery is a procedure to undo or remove the hole that was surgically made in your abdomen to handle solid waste. This hole — called a stoma — is created within your abdominal wall to provide a passageway for your colon to eliminate digestive waste.
A temporary stoma might be created to reroute the flow of solid waste from your rectum for conditions like:
- diverticulitis
- colorectal cancers
- inflammatory bowel disease (IBD)
Although these conditions may sometimes require a permanent colostomy, the goal in most cases is to reverse the colostomy and restore bowel function.
When colostomies are temporary, the reversal procedure will usually take place at least 3 months after your initial surgery.
The procedure to reverse your colostomy is simpler than the procedure to create your stoma, but you will still need to undergo surgery, which has potential complications.
The decision on when, how, and even if a colostomy is reversed will depend on your specific reason for the colostomy and your individual health.
Candidates for colostomy reversal are typically younger and healthier. If you had a colostomy to treat a traumatic wound or diverticular disease, you may also be a candidate for reversal surgery.
On the other hand, if any of the following apply to you, you may not be considered for this procedure:
- you’re an older age
- you have a malignant disease like cancer
- you have cardiovascular disease
If you have a volvulus or ischemic bowel — when your intestines are twisted or damaged — it can also limit your chances of a reversal. According to one 2022 study,
The process of reversing your colostomy begins with an assessment of your healing. Sometime around
If the initial reason for your bowel diversion has been treated and addressed, your doctor will make sure you have not developed postoperative complications like strictures or adhesions that could delay or prevent a successful reversal.
If the plan is to move forward in reversing your colostomy and restoring your natural bowel function, you will be scheduled for surgery.
During the procedure, a surgeon will:
- make an incision around the stoma site
- access your abdominal tissue through the stoma site
- reattach the remaining sections of your colon to each other (anastomosis)
- close the incision site
These steps can vary based on how your original colostomy was done and any other health issues you may have.
One of the biggest risks of colostomy reversal surgery is failure.
There are various reasons why a colostomy reversal fails, but fluids leaking from the area where the two ends of your colon were rejoined is a common cause.
This leakage can lead to poor wound healing, infection, or even sepsis.
A research review in 2017 suggests that the overall risk for complications is
Other possible complications of stoma reversal include:
- bowel obstructions
- opening of the surgical wound
- infection
- scarring or other problems that prevent reconstruction
Most people who undergo colostomy reversal surgery will stay in the hospital for 3–10 days after the procedure. The main goal during this time is to monitor your wound healing and make sure you’re able to pass stool naturally through your reconnected colon.
It will take some time after surgery for your bowel movements to become regular. Either constipation or diarrhea is expected for some time.
Your surgical wound will take 2–3 months to heal, and your anus may be tender as you get used to natural elimination habits again.
While your body adjusts to the reversal, you may find that powders or barrier ointments help with anal irritation and odor. You will also want to gradually reintroduce foods that could irritate your bowel during the recovery period.
Your treatment team will give you specific instructions for your diet and wound care after the procedure based on the type of reversal that was done and any other health issues that need to be considered.
How successful a colostomy reversal is will depend on factors like:
- why the colostomy was done in the first place
- any complications that occurred when the stoma was created
- what ongoing treatments were happening, such as chemotherapy or radiation
Even with successful colostomy reversals, the risk of failure, infection, and ongoing complications is high, so many people who begin with temporary colostomies decide to never have their stoma reversed.
This is a decision best made between you and your healthcare team based on your individual health and risk of complications.
Most colostomies are done with the intent of being temporary, but the high risk of infection and failure with reversal surgery keeps many people from even attempting to regain natural bowel function.
Infections and leaking are some of the most common complications. Infections have the potential to progress to sepsis and become life threatening.
It may be helpful to talk with your doctor about your individual needs and risk factors when considering a colostomy reversal.
