Stoma reversal

Stoma reversal (closing a stoma) is when the bowel used to form the stoma is reconnected to the remainder of the bowel internally. Reversal is not always possible.

If your rectum has been removed you will not be suitable for stoma reversal, as waste can’t leave your body in the normal way without it.  

If and when you might have a stoma reversal depends on: 

• If you have recovered from your first surgery and your bowel has healed.
• If you need any more treatment such as chemotherapy or radiotherapy. You will need to finish and recover from these treatments before stoma reversal can be considered. 
• If your bowel is healthy - For example, there is no disease in your bowel and no narrowing of the bowel. 
• If the muscles around your back passage (anal sphincters) are working. These control the flow of waste and wind from your bowel and so are needed for normal bowel function.
• If you’re medically fit to have more surgery. 

Your surgeon will talk to you about whether you might be suitable for stoma reversal surgery. You may need to have more tests to give your surgeon more information.

Often stoma reversal happens anytime from few months after the stoma was made to 1 or 2 years later. 

Stoma reversal surgery may be delayed or may not be suitable for you, so try not to focus too much on reversal, and instead focus on adjusting to living with a stoma. 

You may prefer not to have more surgery, even if reversal is an option for you. 

Getting used to life without a stoma

The vast majority of people who have had their stoma reversed look forward to getting on with their lives without the stoma.

Some people’s bowel pattern may not return to how it was before their cancer treatment, but generally people adapt to a ‘new normal’ routine for their bowels and manage very well.

Bowel function often improves over time. This can vary from weeks to months and even years for some people. A minority of people will have more significant bowel function problems after stoma reversal. They may need more support from health care professionals and possibly further medical procedures. 

Possible bowel changes include:

• Needing to go to toilet more often, including during the night
• Needing to rush to get to the toilet in time
• Diarrhoea 
• Doing lots of small bowel motions rather than one big one
• Feeling that you need to poo all the time or that you haven’t emptied your bowel fully
• Bowel motion leaking from your back passage 
• Constipation
• Sore skin around the back passage

These changes can be upsetting. You may feel embarrassed or worry about how bowel changes will affect your day-to-day life or your sexual relationships.

Stay in touch with your medical team and let them know if you are having any problems. They can advise you on things that may help such as:

• Changes to your diet
• Medication
• Skin care
• Pelvic floor exercises
• Anal plugs
• Talking to a physiotherapist

It can take time to adjust to life after bowel cancer surgery, but most people learn to manage and adapt to any changes.