An ileostomy is a surgical process in which an incision is made in the abdominal wall and it prevents abdominal walls from any damage. Feces pass through this opening, termed as stoma, without passing through the rectum. In some cases ileostomies are permanent but on the other hand, a reversal is required.
A surgeon creates an ostomy in case of any trauma or colorectal cancer. It is performed to prevent bowel leakage in the abdomen, which can be fatal, after the surgery.
If the surgery is successful then a patient undergoes ileostomy reversal.
This article will help you to understand ileostomy reversal in more depth, also the complications and aftercare.
Procedure:
This procedure is completed in 40 minutes. Following events occur during the surgery:
- A hole will be created by the surgeon in the abdomen so he can access the ostomy down to the connective tissue around the intestines, called fascia.
- Then they will decide which the area for joining two parts of any intestine.
- Next, they will join these two intestinal parts together. This is often termed anastomosis.
- At last, they will close the connective tissues around the intestine and the hole that was created in the belly.
The perspective of this surgery depends on the initial surgery performed by the surgeon.
For examples, the perspective can vary in:
- Orientation of the incision
- Closing method of anastomosis
- If the surgeon has used a synthetic mesh over fascia in order to avoid a hernia.
It is necessary for a surgeon to discuss the complications with the patient before and after the surgery.
Timing:
There are different factors that contribute to the timing of the reversal post-surgery. These can be the following:
- Recovery record of the original ileostomy.
- Whether a person needs a chemo or radiotherapy following the surgery.
- Stage of cancer
- Surgeon and the patient’s preference
According to the most of the researches a post-surgery are done 3 -6 months following an original ostomy, until there are no issues or complications related to initial surgery.
Whereas the study shows that early stoma closure prevents any complications rather than the late stomal closure.
According to study in 2015, patients who have a gap of 6 months between both surgeries has more chances to develop complications.
Complications:
· Hernia: If there is bowel leakage directly into the abdominal cavity, this will cause a hernia. It can occur at the location near the wound or the scar. Old age people have higher chances to get a hernia, which shows within the time period of 2 years of the ileostomy.
· Anastomotic leakage: It’s a very rare situation. In this case, there is leakage at the point of bowel junction. Another surgery is needed to overcome this issue.
· Abdominal leakage: In this case, infected fluids accumulate inside the abdomen. This can cause inflammation, high fever, and bowel discomforts. This can be treated by bowel drainage and taking antibiotics.
When to see your doctor:
If a patient notices any of the listed signs, he or she must contact his doctor immediately.
Leakage or blockage
These signs include:
- Intense stomach pain
- Inflammation
- Vomiting
- Nausea
- Short breath
- Unusual Fatigue
- Difficulty in water consumption
- Discomfort during passing urine
- Diarrhea
Infection
There are the chances that fluid present in the abdomen can be infectious. See your doctor if you feel following signs:
- Temperature
- Pain
- Bloating
- Worsening diarrhea
Healing:
Usually, it’s necessary for a person to wait for the healing of the ileostomy and the incision, following reversal surgery.
It has been reported that reversal surgery takes less time for healing as compared to the initial ileostomy surgery. Maybe a patient has to stay in the hospital for 3-4 days.
A person should remain calm and should know the fact that it will take some time to regain normal bowel functioning. Initially, a patient will notice small but frequent movements and passing of gas. A patient needs to stay in hospital until their bowel movements get back to normal.
The incision that was made usually takes 4-6 weeks for a full recovery.
Recovery:
A patient needs to discuss the details with the doctor about the ileostomy reversal.
As soon as the feces start to pass normally through the rectum, the doctor will suggest the following tips for a speedy recovery.
· Diet:
A patient is advised by a doctor to have selected food items, following their reversal ileostomy. A A low fiber diet called BRAT is suggested to prevent frequent bowel movements. BRAT means:
B stands for bananas
R stands for rice
A stands for applesauce
T stands for toast
It is recommended to have small meals several times instead of eating a lot at a single time. This will prevent any kind of discomfort or inflammation.
The foods that should not be taken by the patients are:
- Chocolates
- Coffee
- Juices
- High carbs food
- Spicy food
- Sugarless food items
· These food items can cause gas and stomach pain.
Bowel movements:
It is often hard to pass feces after the surgery, since the rectum needs to regain elasticity so that it can store feces again.
Bowel discomforts can be prevented by:
- Applying any kind of moisturizer or skincare product, for example, petroleum jelly or baby jelly; around the anus area right after the bowel movement.
- Soak yourself in Luke warm water, for at least three times a day.
- Use hydrated wipes to clean the anus after passing stool.
- Taking any prescribed medicine
Physical Therapy
Usually, pelvic floor therapy is recommended by doctors. It will help a patient’s pelvic floor muscles to pass a stool normally.
But most of the doctors suggest waiting for a minimum of 6 weeks following the ileostomy reversal, starting this therapy.
Conclusion:
Ileostomy reversal surgery assists a person to have normal bowel movements and stool passing.
This is less protruding less painful and less time taking than the initial ileostomy. Therefore a patient recovers more fatly.
A patient needs to be careful about the diet and bowel movements.
A physician, nutritionist, or a physical therapist can help a patient to avoid any kind of complications and to recover speedily.
