Colostomy reversal surgery requires careful attention, especially regarding diet. Since your colon is reconnected and functional, the food you consume plays a crucial role in healing and bowel function. Consuming foods that are hard to digest can worsen your condition. A well-planned diet can prevent complications like infections, bowel obstructions, and nutritional deficiencies, while also reducing common post-surgery symptoms such as diarrhea, constipation, and bloating. This article explores the best foods to incorporate into your diet after colostomy reversal surgery, and which foods to avoid.
Understanding Colostomy and its Reversal
A colostomy is a surgical procedure that creates an opening (stoma) in the abdominal wall, through which a portion of the colon is brought to the surface of the skin. The end of the colon is then attached to the stoma, allowing waste to leave the body through this new opening, rather than through the rectum and anus. Colostomies can be temporary or permanent. A temporary colostomy is often performed when the colon is infected and needs time to heal, while a permanent colostomy is performed when part of the colon is removed completely.
Colostomy reversal, also known as colostomy takedown or closure, is a surgical procedure designed to reverse a temporary colostomy. During this surgery, the section of the intestine that was brought outside the abdomen is brought back inside and reconnected to the rest of the intestine. Colostomy reversal surgery is performed in cases of temporary colostomy where the purpose of stoma formation is to allow the colon healing time. Conditions such as diverticulitis, Crohn’s disease, and colorectal cancer may require temporary colostomies. After about 6 months, your surgeon will evaluate your overall health and underlying disease conditions. If you have healed properly, your surgeon may recommend the colostomy takedown procedure.
The Importance of Diet After Colostomy Reversal
Diet is extremely important after colostomy reversal surgery for proper healing and a smooth transition. After surgery, your bowel needs time to heal and function properly. Here are some of the reasons why diet is important:
- Supports Healing: A balanced diet provides essential nutrients such as proteins, vitamins, and minerals that are crucial for tissue repair and overall recovery. Adequate nutrition helps the body rebuild and restore the intestinal tract and surrounding tissues after surgery.
- Regulates Bowel Movements: After colostomy reversal, your bowel needs time to adjust to its new function. A well-planned diet helps regulate bowel movements, preventing issues like constipation and diarrhea.
- Reduces Complications: Certain foods can irritate the digestive system or cause blockages, especially in the initial stages of recovery. By following dietary guidelines, you can minimize the risk of complications such as bowel obstructions, infections, or excessive gas and bloating.
- Enhances Comfort: Eating easy-to-digest foods in small, frequent meals can significantly enhance comfort during the recovery period.
What to Eat After Colostomy Reversal
Start with a Low-Residue Diet
The goal of starting with a low-residue diet is to minimize bowel movements and reduce irritation. Maintain a low-residue diet for the first few weeks after surgery.
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Foods to Include: White bread, refined cereals, white rice, lean meat, and poultry. It’s best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are cooked, easy-to-digest foods that aren’t spicy, heavy, or fried.
Introduce Fiber Gradually
The purpose of incorporating fiber into your diet is to promote regular movements without causing any strain. Be cautious to introduce food slowly and observe your body's response. Only add 1 food at a time. Make sure you’re also drinking enough liquids.
Foods to Include: Oatmeal, peeled apples, bananas, carrots, and squash. Some fruits may cause discomfort for some people. If a certain fruit causes discomfort, don’t eat it.
Stay Hydrated
Maintaining hydration is very important, especially after colostomy reversal surgery. Drink plenty of water and other fluids. You can enjoy herbal teas, clear broth, or herbal solutions. Drink plenty of fluids to avoid constipation (around 8 glasses per day).
Add Lean Protein
Lean protein is extremely important for quick healing and recovery as it helps in tissue repair. Chicken, fish, and eggs are good sources of lean protein.
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Add Healthy Fats
Fats provide energy and support the cellular repair system. Good sources of fat are olive oil, nuts, and avocado. When eating fats, start with a small amount.
Eat Small and Frequent Meals
It’s better to have frequent small meals than to have larger ones. Eating small and frequent meals will be easier on the digestive system and nutrients can be absorbed easily. For instance, instead of three large meals a day, try six small meals.
Foods to Avoid After Colostomy Reversal
The following food items should be avoided after colostomy surgery:
- High-Fiber Foods Initially: Avoid high-fiber foods right after the surgical procedure because fiber-rich foods can cause bowel irritation and increase stool bulk.
- Gas-Producing Foods: Avoid gas-producing foods as they can lead to discomfort and bloating. Examples include beans, carbonated drinks, and cruciferous vegetables.
- Spicy and Fried Foods: Avoid spicy and fried foods as they can cause irritation in the digestive tract.
- Dairy Products (if lactose intolerant): Some people develop temporary lactose intolerance. If this occurs, it is recommended to avoid dairy products after colostomy reversal surgery.
Tips for a Smooth Dietary Transition
- Eat Small and Frequent Meals: This is easier on the digestive system and allows for better nutrient absorption.
- Chew Food Thoroughly: This aids in digestion and reduces strain on the bowel.
- Avoid Problematic Vegetables: Avoid vegetables that increase flatulence, such as cabbage and onions.
- Limit Alcohol and Fizzy Drinks: Avoid alcohol and fizzy drinks until completely healed.
- Monitor Your Progress: Keep a close eye on your body’s response to different foods.
Monitoring Your Progress
After colostomy reversal surgery, it's crucial to monitor your body’s response to different types of food. Remember, you know your body best. After consuming anything, observe the following points:
- Stool Consistency: Ideally, you should have soft and well-formed stools. If the stool consistency is too runny, there may be a problem with your diet. Mashed potatoes, bananas, jelly sweets and marshmallow are good for firming up loose stools.
- Frequency of Bowel Emptying: Once your colon is healed, your bowel movement will gradually become regular.
- Signs and Symptoms: Keep a strict check on signs and symptoms of bloating or diarrhea. If you consume anything that causes diarrhea, adjust your diet accordingly.
Managing Common Problems
After your surgery, you may have some food intolerances that you didn’t have before surgery. A food intolerance is when eating a certain type of food causes uncomfortable symptoms, such as diarrhea, bloating, gas, or bad odor. No 2 people will react the same way to food.
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Diarrhea
Diarrhea is having loose or watery bowel movements, having more bowel movements than what’s normal for you, or both.
Foods to Avoid:* Caffeine
- Alcohol
- Dairy products
Foods to Eat More Of:* Bananas
- White rice
- Applesauce
- Toast
Constipation
Constipation is having fewer than 3 bowel movements per week, having hard bowel movements, having a hard time passing bowel movements, or all 3.
Foods to Avoid:* Cheese
- Meat
- Processed foods
Foods to Eat More Of:* Prune juice
- High-fiber bread
- Fruits and vegetables
Gas and Odor
For the first few weeks after your surgery, it’s common to have gas in your pouch and a bad odor when you open your pouch.
Things to Avoid:* Chewing gum
- Drinking with a straw
- Skipping meals
Foods to Eat Less Of:* Broccoli
- Brussels sprouts
- Cabbage
- Onions
Foods to Eat More Of:* Cranberry juice
- Parsley
- Yogurt
Understanding Ostomy Reversal
An ostomy reversal is an operation to reverse an existing colostomy or ileostomy. You might have an ostomy if you’re recovering from an injury or disease in your bowel that prevented you from using it normally. After your bowel has recovered, you might be a candidate for ostomy reversal surgery. A surgeon creates a colostomy or ileostomy by splitting your bowel and redirecting the end of your large intestine (colon) or small intestine (ileum) to an opening in your abdomen (a stoma). Ostomy reversal surgery connects your bowels and closes your stoma, allowing you to poop out of your anus (butthole) once again.
Why is Ostomy Reversal Done?
Ostomy reversal is an elective procedure that you can choose to have if your condition allows for it. Most people choose to have it because they’d prefer to use the bathroom in the old-fashioned way again. This procedure represents a chance to return to the way life was before ostomy surgery. After your reversal, you’ll no longer have to worry about managing an ostomy bag or caring for your stoma, or the various complications that can come with having an ostomy, like leaked fluids and irritated skin. In short, reversal offers relief from the practical and psychological burdens of living with an ostomy.
When Can a Colostomy or Ileostomy Be Reversed?
Your surgeon will discuss the possibility of ostomy reversal with you before your original colostomy or ileostomy procedure. This possibility will depend on the nature of your condition, the type of treatment you need and how well you recover from it. Ostomy reversal may not be an option for everyone. If your surgeon expects your ostomy to be permanent, they might complete it in a more permanent way (end ostomy). But if they expect it might be temporary, they can complete it in a less permanent way (loop ostomy).
Types of Colostomy Reversal Surgery
There are two main types of colostomy reversal surgery:
- Loop Colostomy Reversal: A loop colostomy brings a loop of bowel with two openings to the skin surface. Reversal of a loop colostomy, often called a stomal closure, is usually straightforward since both ends of the bowel are already close together. The surgeon detaches the loop from the abdominal wall and reconnects the bowel before returning it inside.
- End Colostomy Reversal: An end colostomy has only one opening. The other end of the colon or rectum is closed inside the abdomen. This end is called the colon stump or rectal stump. Reversal of an end colostomy is often called a stoma takedown or Hartmann reversal. This procedure is more complex than a loop colostomy reversal because the surgeon must reopen the prior scar, locate the internal colon or rectal stump and reconnect it to the colostomy end.
What to Expect During and After Colostomy Reversal
Colostomy reversal surgery can be performed using either an open or a minimally invasive laparoscopic approach. Open surgery involves making a long incision in the belly, giving the surgeon full access to the bowel and surrounding structures. Minimally invasive colostomy reversal is done laparoscopically, using several small incisions, a camera, and specialized tools to reconnect the bowel.
After colostomy reversal surgery, your body needs time to heal and adjust to the return of typical bowel function. At first, your diet will consist of fluids and soft, low-fiber meals. It is typical to have frequent or urgent passing of stool and loose stools after reversal. This can last for weeks or months as your bowel adjusts.
Home Care After Surgery
Right after surgery, you will be on a liquid diet. Then you'll gradually work up to a soft diet. Eat 5 or 6 smaller meals per day. Limit foods that irritate your digestive system or cause gas. Limit fizzy drinks, alcohol, and caffeine. Take short walks daily to regain your energy and help your surgery site heal. Exercise also helps keep your bowels moving. Don’t lift anything heavy for 6 to 8 weeks. Don't twist or bend at the waist. Shower when your doctor says it’s okay. You may return to driving and work when your doctor says it’s okay.
Your bowel control may be irregular for a few months after surgery. You may have loose bowel movements or constipation, pain, and possibly some incontinence. These will ease with time. Wearing adult incontinence briefs and protecting your skin are important until then. Clean your anus with warm water after every bowel movement to stay clean. Use a barrier cream to help protect your skin. Your doctor may recommend pelvic muscle retraining or biofeedback to help regain sphincter strength.
When to Contact Your Doctor
Contact your doctor right away if you have:
- A fever of 100.4°F (38°C) or higher, or as advised by your doctor.
- Pain or tenderness in the leg or arm.
- Increased pain, redness, swelling, bleeding, or foul-smelling drainage at the incision site.
- An incision that separates or comes apart.
- Pain or hardness in your belly that gets worse or isn’t eased by pain medicine.
Risks and Side Effects of Stoma Reversal Surgery
All surgeries carry a degree of risk. Below are some side effects and risks that are associated with a stoma reversal. Your surgeon will explain any potential complications in details with you during your pre-assessment.
- Ileus - where the bowel stops working temporarily
- Anastomotic leak - the new join in the bowel can come apart and leak into the abdominal cavity
- Bowel obstruction/ adhesions - due to scar tissue forming in the bowel
- Risk of hernia
- Chest infection
- UTI
- Blood clots
- Infection