Colostomy Reversal

Understanding Colostomy Reversal: A Comprehensive Guide


A colostomy reversal is a surgical procedure that aims to restore normal bowel function after a temporary colostomy. A colostomy is created when a portion of the colon is diverted to the abdominal wall to allow healing or recovery of the digestive system. Colostomy reversals, also known as colostomy closure or takedown, involve reconnecting the colon and restoring continuity. This article provides a detailed overview of colostomy reversal, covering indications, surgical procedures, recovery, and long-term considerations.

Indications for Colostomy Reversal

Colostomy reversals are typically considered for individuals who have undergone a temporary colostomy due to various medical conditions, including:

  • Bowel Resection: Removal of a portion of the colon due to diseases such as colorectal cancer or diverticulitis.

  • Trauma or Injury: Cases where the bowel needed temporary diversion for healing after injury or surgery.

  • Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease or ulcerative colitis that necessitate a temporary colostomy.

Preoperative Preparation

Before undergoing a colostomy reversal, patients undergo a thorough preoperative evaluation, including:

  • Medical Assessments: Blood tests, imaging, and other diagnostic tests to assess overall health and the condition of the remaining bowel.

  • Nutritional Assessment: Ensuring adequate nutrition for optimal healing and recovery.

  • Bowel Preparation: Cleansing the bowel before surgery to minimize the risk of infection.

Surgical Techniques

Colostomy reversals involve different surgeon preferred surgical techniques, depending on the location of the colostomy and the specific circumstances:

  • Incision: A surgical incision is made over the colostomy site, allowing access to the abdominal cavity.

  • Reconnection of Bowel: The disconnected ends of the colon are carefully reattached, restoring continuity.

  • Closure of Abdominal Incision: The incision is closed with sutures or staples.
  • Recovery and Postoperative Care

    Recovery from colostomy reversal involves several key aspects:

  • Pain Management: Patients receive pain medication to manage postoperative discomfort.

  • Dietary Progression: Gradual reintroduction of food to allow the digestive system to adjust.

  • Monitoring for Complications: Close monitoring for potential complications such as infection, bleeding, or bowel obstruction.

  • Physical Activity: Gradual resumption of physical activity under the guidance of healthcare professionals.
  • Complications and Risks

    While colostomy reversals are generally safe, potential complications may include:

    • Infection: Risk of infection at the surgical site.

    • Bowel Obstruction: Adhesions or narrowing of the bowel may cause obstruction.

    • Anastomotic Leak: Rarely, a leak may occur at the reconnection site.

    Long-Term Considerations

    Long-term outcomes and considerations following colostomy reversal include:

    • Bowel Function: Adjustments in bowel habits and function after the reversal.

    • Follow-up Care: Regular follow-up appointments to monitor recovery and address any issues.

    • Quality of Life: Improvement in overall quality of life, including psychological and social aspects.


    Colostomy reversal is a significant milestone for individuals who have undergone a temporary colostomy. While the procedure carries risks, careful preoperative evaluation, surgical expertise, and postoperative care contribute to successful outcomes. Patients are encouraged to engage in open communication with their healthcare team including their NSWOC (Nurses Specialized in Wound, Ostomy and Continence) to address any concerns and ensure a smooth transition back to normal bowel function. Ultimately, colostomy reversal plays a crucial role in restoring the health and well-being of individuals who have temporarily relied on a colostomy.

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