Learning About Stoma Reversal Surgery in Children

During your child's ostomy surgery, the bowel was separated and attached to an opening made in the skin of your child's belly. The opening is called a stoma. In a reversal surgery, your child's bowel is reattached inside their body. The stoma is also closed.

A stoma reversal is done after the original ostomy surgery has healed. This most often takes at least 6 to 8 weeks. But sometimes it can take 12 months or longer. Stoma reversal can be done if there's enough healthy bowel left to be rejoined and the anal muscles are working.

The doctor rejoins the ends of the bowel that were separated. The part of the belly where the stoma was is then closed with stitches.

How the stoma reversal is done depends on what type of ostomy surgery your child had. One type of surgery involves making a large cut (incision). This way takes longer to heal. The other type uses smaller cuts and a small lighted tube called a scope. It doesn't take as long to heal.

It's common for children to have problems with how the bowel works after a stoma reversal surgery. Your child may have frequent bowel movements. Some children have symptoms such as constipation, loose stool, incontinence (leaking stool), sudden bowel urges, a skin rash, or pain. Other risks include infection in the belly and blockage in the bowel from scar tissue in the belly.

Symptoms usually get better over time. But some may remain over the long term.

Your child may need to take the same precautions as after the ostomy surgery. The doctor can tell you when it's okay for your child to return to activities and routines. This may take up to several weeks or months.

Your doctor may recommend things you can do at home to help improve how well your child's bowel works. You may be told to:

• Change your child's diet. As your child's bowel heals, you may work with a dietitian to know what foods are best.
• Give your child small, frequent meals.
• Have your child drink plenty of fluids.
• Use foods and medicines to make sure that your child has at least one bowel movement a day.
• Keep a food diary. You can use it to track what your child eats and how foods affect your child.

Your child can do most of their usual activities. Talk with your child's doctor about any restrictions, such as for contact sports.

Now that stool is passing through the anus, it is important to keep your child's bottom clean and dry to help prevent a rash. The doctor may suggest creams to help with a rash or soreness around the anus. You may also be told to give medicines for constipation or loose stool.

Your child's care team can help you with any ongoing problems.