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What Is Colostomy Reversal?

Colostomy reversal is surgery that closes a temporary colostomy and restores passage of stool through the remaining colon and rectum. The surgeon frees the bowel from the abdominal-wall stoma and reconnects bowel segments when an anastomosis is required. The opening in the abdominal wall is then closed or allowed to heal using a planned wound-care method. The operation is possible only when the bowel and the patient are suitable for safe reconnection.

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What Is Colostomy Reversal?

Colostomy reversal is surgery that closes a temporary colostomy and restores passage of stool through the remaining colon and rectum. The surgeon frees the bowel from the abdominal-wall stoma and reconnects bowel segments when an anastomosis is required. The opening in the abdominal wall is then closed or allowed to heal using a planned wound-care method. The operation is possible only when the bowel and the patient are suitable for safe reconnection.

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Why Is Colostomy Reversal Performed?

A reversal is performed when the condition that required a temporary colostomy has resolved enough for intestinal continuity to be restored. Common reasons for the original stoma include colorectal surgery, bowel injury, perforation, diverticulitis, obstruction, or the need to protect a healing bowel connection. Before reversal, clinicians assess overall health, nutritional status, the downstream bowel, continence, and the healing of prior surgery. Some colostomies cannot or should not be reversed because the risks of reconnection are too high.

How Is Colostomy Reversal Performed?

The operation is performed under general anesthesia and can require open or minimally invasive abdominal surgery depending on the original operation and internal scar tissue. The surgeon separates the colostomy from the skin and abdominal wall and identifies the bowel segment that will be reconnected. The bowel ends are joined with sutures or a surgical stapling device, or a loop colostomy is closed according to its anatomy. The former stoma site and any abdominal incisions are then managed using the surgeon's planned closure technique.

What Is Recovery Like After Colostomy Reversal?

Bowel function can be slow or irregular after reversal while the intestines recover from surgery and adapt to the restored pathway. Patients can initially experience frequent stools, urgency, loose stools, constipation, gas, or difficulty predicting bowel movements. Eating is advanced as bowel function returns, and walking is encouraged while heavy lifting is restricted during abdominal healing. Recovery can be longer after reversal of an end colostomy or Hartmann procedure than after closure of a simpler loop stoma.

What Are the Risks and Complications?

Possible complications include bleeding, wound infection, ileus, bowel obstruction, hernia, blood clots, and injury to nearby organs. Leakage from the new bowel connection is a serious complication that can cause abdominal infection or sepsis and can require another operation or a new stoma. Scar tissue from previous operations can make reversal technically difficult and increase operative risk. Some patients develop persistent changes in bowel frequency, urgency, continence, or quality of life after the stoma is closed.

Frequently Asked Questions About Colostomy Reversal

Can every colostomy be reversed?

No. Reversal depends on why the colostomy was created, the condition of the remaining bowel, healing, continence, overall health, and surgical risk.

Is a colostomy reversal major surgery?

It can be. Loop-stoma closure can be relatively limited, while reversal of an end colostomy or Hartmann procedure can require extensive abdominal surgery.

Will bowel movements be normal immediately after reversal?

No. Frequency, urgency, stool consistency, and control commonly change during the early recovery period. Bowel function can continue adapting over time.

Can a new stoma be needed after reversal?

Yes. A new temporary or permanent stoma can be required if the bowel connection leaks, healing fails, or another serious complication develops.

References

Ileostomy & Colostomy (Ostomy) Reversal. Cleveland Clinic. https://my.clevelandclinic.org/health/procedures/ostomy-reversal. Date Accessed August 12, 2026.

Reversal of Stoma (Ileostomy or Colostomy). North Bristol NHS Trust. https://www.nbt.nhs.uk/our-services/a-z-services/colorectal-cancer-services-surgery/colorectal-patient-information/reversal-stoma-ileostomy-or-colostomy. Date Accessed August 12, 2026.

Considerations in Stoma Reversal. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC5498167/. Date Accessed August 12, 2026.

Diverticular Disease Expanded Information. American Society of Colon and Rectal Surgeons. https://fascrs.org/Web/Web/Patients/Diseases-and-Conditions/A-Z/Diverticular-Disease-Expanded-Information.aspx. Date Accessed August 12, 2026.

Reversal of Hartmann's procedure. Gloucestershire Hospitals NHS Foundation Trust. https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/reversal-of-hartmanns-procedure/. Date Accessed August 12, 2026.