Medical Oncologist
CION Cancer Clinics
Stoma reversal: the operation, the stay and the months after | CION Cancer Clinics
Stoma reversal is a second operation that closes a temporary stoma and joins the bowel back up, so stool passes through the back passage again. Not every stoma can be reversed. Your team first checks that the join has healed and that you are fit for surgery. Afterwards, bowels are often frequent and urgent for months. This page explains each stage, and what only your surgeon can decide. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Can a stoma be reversed, and what does reversal involve?
- Which stomas can be reversed, and which cannot?
- What happens in the weeks before the operation?
- What happens on the day and during the stay?
- What will my bowels be like after reversal?
- What do families often believe about reversal?
- Common questions about stoma reversal
The short answer
Can a stoma be reversed, and what does reversal involve?
Many stomas made during cancer surgery are meant to be temporary, and those can often be reversed. Reversal is a second, usually smaller operation that closes the stoma and joins the bowel back up, so that stool passes through the back passage again.
Why a temporary stoma was made at all
When a surgeon removes part of the bowel and joins the two ends, that join needs time to heal. Stool passing over a fresh join can make it leak. A temporary stoma lets the stool leave the body higher up while the join rests. It is a protection, not a sign that something went wrong.
What the operation usually is
For a loop ileostomy or loop colostomy, the surgeon frees the loop of bowel through the stoma opening, closes the hole in it and places it back inside. There is often no need to reopen the old scar. Where the whole end of the bowel was brought out, as after a Hartmann's operation, reversal is a bigger operation through the abdomen, sometimes by keyhole surgery.
What this page cannot tell you
It cannot tell you whether your own stoma can be reversed, or when. That depends on the operation you had, how the join has healed, your treatment plan and your general health. Only your surgical team can weigh those together.
Temporary or permanent
Which stomas can be reversed, and which cannot?
The type of stoma and the reason it was made matter more than how long you have had it.
Loop ileostomy
The most common temporary stoma after rectal cancer surgery. It protects a low join in the bowel. Most are planned for reversal once the join has healed and other treatment has finished.
End colostomy after a Hartmann's operation
Often made in an emergency, such as a blocked or burst bowel. The lower end of the bowel is closed off inside. Reversal is possible for some people, but it is a larger operation and not everyone is offered it.
Permanent colostomy
When the back passage and its muscle ring have been removed, there is nothing to join the bowel back to. This stoma is made to stay.
Usually after
- Removal of a very low rectal cancer with the anus
- Some anal cancers that return after treatment
Urostomy
Made when the bladder is removed, using a short piece of bowel to carry urine out. It is not reversed.
When reversal may not suit
Even a stoma planned as temporary is sometimes kept. Your team weighs these things before offering an operation.
- Cancer still present, or returned, in the pelvis
- Weak muscle control at the back passage
- A join that has not healed or has narrowed
- Heart, lung or other health problems that make surgery unsafe
Not sure whether this applies to you?
Ask an oncologistGetting ready
What happens in the weeks before the operation?
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Finishing other treatment
If chemotherapy was planned after your cancer surgery, reversal is usually done after it ends. The stoma often makes chemotherapy easier to get through, because the join is protected while your body is under strain.
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Checking the join
The team needs to see that the join has healed without a leak or narrowing. This is often an X-ray where a liquid that shows up on the pictures is passed gently into the back passage. Some people have a camera test of the lower bowel instead, or as well.
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Checking the muscle ring
Your surgeon may examine the back passage and ask how well you controlled your bowels before surgery.
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Fitness and medicines review
Blood tests, a heart tracing and an anaesthetic check are usual. Bring a list of every medicine you take, including blood thinners and diabetes tablets. The team will tell you which to continue. Do not change any on your own.
In hospital
What happens on the day and during the stay?
The operation
You are fully asleep under general anaesthesia. A loop reversal is often shorter than your first operation.
The old stoma site
The skin may be stitched closed, or left partly open to heal from the inside out with dressings.
Waiting for the bowel to wake
The bowel often goes quiet after being handled. You will start with sips, then soft food. Passing wind or a first motion from the back passage is the sign the team is watching for.
Going home
Most people go home once they are eating, passing motions and walking. The length of stay varies with the type of reversal.
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The honest part
What will my bowels be like after reversal?
Expect them to be unsettled at first. Many people go to the toilet often, with little warning, and pass small amounts each time. For most, this improves slowly over the following months, though it may not return fully to how it was before cancer.
Why it happens
The rectum is the part of the bowel that stores stool until you are ready. After rectal cancer surgery it is shorter, or replaced by a join, so it holds less. Radiotherapy to the pelvis can also make the area stiffer. Doctors call this LARS, meaning bowel changes after removal of the lower bowel.
What you may notice
Frequent or urgent motions, clusters of visits close together, leaking of wind or stool, and sore skin around the back passage. Some people swing between loose motions and constipation.
What usually helps
Regular meals, keeping a simple diary of food and motions, pelvic floor exercises and barrier cream for the skin. Your team may suggest medicines to firm the stool or slow the bowel. A specialist nurse or physiotherapist can guide you if progress stalls. If control stays very poor, some people later choose a permanent stoma with their team.
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Signs that cannot wait after reversal
In the first weeks at home, go to the hospital the same day if you have increasing pain in the belly, a fever or shivering, a fast heartbeat, a swollen and hard belly, repeated vomiting, or no motions and no wind at all. These can be signs that the join is leaking or the bowel is blocked. Do not wait until morning, and do not take painkillers first to see if it settles.
Commonly believed
What do families often believe about reversal?
"Once the stoma is closed, life goes back to exactly how it was."
Often it does not, at least not straight away. The bowel has to adapt, and the first months can be harder than living with the bag. Knowing this early helps you plan time off work.
"The sooner it is reversed, the better."
Timing is chosen for safety. The join must heal, other treatment may need to finish, and you need to be strong enough for another operation. Rushing reversal to be rid of the bag can put the join at risk.
"If they did not reverse it, the cancer must be back."
Not necessarily. Stomas are kept for many reasons, including weak muscle control, a join that has narrowed, or health problems that make another operation unsafe. Ask your team directly why the decision was made.
Questions we are asked
Common questions about stoma reversal
How long after the first operation is a stoma reversed?
It varies. Some reversals happen within a few months, others after chemotherapy ends, which can take much longer. The team waits until the join has healed on testing and you have recovered your strength. Ask your surgeon what they are waiting for in your case, so the delay does not feel unexplained.
Is reversal a big operation?
Closing a loop stoma is usually smaller than the first operation, often done through the stoma opening itself. Reversing an end colostomy after a Hartmann's operation is a larger operation on the abdomen. Both need a general anaesthetic and a hospital stay, and both carry risks your surgeon will explain before you agree.
What can go wrong after reversal?
The main concerns are a leak from the join, the bowel being slow to start working, infection of the old stoma wound, and a hernia, which is a bulge, at the stoma site later. Your surgeon can tell you how likely these are for your type of operation. Report pain, fever or vomiting at home straight away.
Will I need to wear pads afterwards?
Some people do for a while, especially at night or when going out, because leaking of wind or stool can happen early on. Keep pads, wipes and spare clothes in a bag at first. Tell your team if leaking continues, because treatments can help.
What should I eat once the stoma is closed?
Start with soft, simple foods such as idli, curd rice and khichdi, eaten in small regular portions. Add other foods one at a time so you can see what upsets the bowel. Very spicy, oily or high fibre foods may make motions more frequent at first. Drink enough water through the day.
When can I go back to work?
This depends on the size of the operation, your job and how settled your bowels are. Desk work may be possible sooner than heavy physical work. Often the toilet visits, not the wound, decide your return. Ask your surgeon about a gradual start.
Can the stoma site bulge later?
Yes, a hernia can develop where the stoma used to be, sometimes months later. It shows as a soft bulge, often clearer when you cough. Follow your team's advice on lifting. See your surgeon if a bulge appears, and urgently if it turns painful and hard.
Is stoma reversal covered by Aarogyasri or insurance?
Often it is, when the reversal is part of the same cancer treatment. Aarogyasri, CGHS, ECHS and EHS may cover it, and many cashless insurers do. Cover rules differ by scheme and policy, so check before admission. Call the helpline with your card or policy details and we will help you find out.
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Dr. Owais Mohammed
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Ileostomy
- NHS — Colostomy
- Cancer Research UK — Bowel cancer
- American Cancer Society — Ostomies
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Colostomy, Ileostomy and Urostomy: How They DifferKnow which stoma you have before asking about reversalLiving With a Stoma: The Complete GuideDay-to-day life while you wait for the operationDiet With a Stoma: What to Eat and AvoidEating well before reversal helps you healComplications and Red FlagsWarning signs after any cancer operationRecovery, Eating and Getting Back to LifeReturning to work and routine after surgery
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