Closure of loop colostomy

At your first consultation, you will be seen by a consultant general or colorectal surgeon, a doctor specialising in general or bowel surgery. They will ask you about your general health and medical history and perform a physical examination. They will need to know everything about any previous treatment you have had and what led to you having the colostomy.

Before your surgery, your consultant will need to check that your bowel and anal muscles are working well enough for you to pass a bowel movement normally. They may order tests or scans including:

• Rectal examination to check your bowel control and anal sphincter strength
• Flexible sigmoidoscopy to determine how well your bowel has healed
• X-rays with contrast dye to check your anastomosis (where the two parts of your bowel were joined together) for any leaks
• CT scan to check for active bowel disease

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your surgery, so please ask your consultant any questions you may have.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have, as well as allowing your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking. Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

Closure of loop colostomy is performed under general anaesthetic which means you'll be asleep for the procedure.

Once the anaesthetic takes effect, your consultant will begin by making an incision (cut) around your stoma.

Next, the cut end of your bowel is reattached to the rest of your bowel with staples or stitches.

Then your consultant will place your bowel back into its correct position. Your incision will be closed, and a sterile dressing applied.

Closure of loop colostomy normally takes around one hour.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your surgery, you will be taken to the recovery room where your blood pressure, breathing and heart rate will be monitored closely until the anaesthetic has worn off. You will then be taken to your room.

How many nights will I need to stay in hospital?

You can normally go home between one and three days after your closure of loop colostomy. If you experience complications during or after your surgery, you may need to spend longer in hospital. Most people go home within ten days of closure of loop colostomy.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your surgery. Please make arrangements for someone to come and collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on how quickly you recover after your procedure and the type of job you do. You should avoid heavy lifting, strenuous activity, pushing, stretching or activities that put pressure on your abdominal muscles for at least ten weeks after your surgery. Talk to your consultant about when you can expect to return to work after your closure of loop colostomy.

How soon can I drive?

You should not drive until you can control your vehicle without pain and perform an emergency stop comfortably. Check with your consultant and inform your insurance company before driving after your closure of loop colostomy.

When will I be back to normal?

Recovery from any surgery is a gradual process that is different for everyone. Closure of loop colostomy is a relatively straightforward procedure and normally has a faster recovery time than the original colostomy surgery. Most people return to normal activities within a few weeks of the procedure.

You may have some soreness when opening your bowels (pooing) after your surgery. This will settle down as you get used to passing bowel movements through your anus again.

You can help relieve soreness and discomfort by washing the skin around your anus with warm water after every bowel movement, patting the area dry with a soft cloth and applying a barrier cream to protect the skin. Avoid using talc, baby wipes or scented toilet paper as these can irritate your skin.

It may take a while for your bowels to return to normal after closure of loop colostomy. You may experience:

• Needing to empty your bowels more often
• Needing to use the bathroom quickly
• Passing more gas than usual
• Difficulty controlling your bowel movements (incontinence) or leakage
• A feeling of not having emptied your bowels completely

These symptoms normally settle down within a few weeks but may take longer in some people. Talk to your consultant if you are worried about your bowel movements after your closure of loop colostomy.

What should I eat after closure of loop colostomy?

Your bowels may be sensitive and irritable for a while after your closure of loop colostomy. It may help to avoid large meals and eating late at night. You can also limit or avoid eating foods that could make irritation worse such as:

• Citrus and acidic fruits such as lemons, oranges, strawberries, grapefruit, and grapes
• High-fat meals
• Spicy foods
• Large amounts of alcohol
• Fizzy drinks
• Vegetables that cause gas like onions, Brussels sprouts and cabbage

Closure of loop colostomy is a generally safe procedure, but as with all types of surgery, there is a small risk of complications.

Your consultant will explain all the possible risks and complications before your surgery and will be happy to answer any questions you may have. It’s important that you are fully informed before your surgery so that you can make an informed decision.

Possible complications of any surgery include:

• Bleeding
• Wound infection
• Chest infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to closure of loop colostomy include:

• Bowel obstruction — this is a rare complication where the bowel may become blocked or narrowed after surgery. If this occurs, you may need another operation
• Paralytic ileus — this can occur when your bowel doesn’t start working for a while after the surgery. Treatment involves resting the bowel and receiving food and fluids through a drip or a tube until the bowel starts working again
• Anastomotic leak — if your anastomosis (the area where your bowels were joined) starts to leak you will be given antibiotics to prevent infection and an operation may be needed to repair the leak
• Problems with urinary or sexual function — this may occur if the nerves supplying the urinary or sexual organs are damaged during surgery. It is more common with other types of colostomy reversal

We answer some of your most commonly asked questions about closure of loop colostomy.

What is a loop colostomy?

A loop colostomy is a type of colostomy where a loop of your large bowel (colon) is diverted out of your body through your abdomen. The loop of bowel is cut and stitched to your skin to form a stoma. Waste (poo) passes out of your body into a bag attached to the stoma.

Can a loop colostomy be reversed?

Yes. A loop colostomy is normally performed as a type of temporary colostomy and can usually be reversed.

How long does it take to recover from closure of loop colostomy?

How long it takes to recover from closure of loop colostomy varies from person to person. You can help your recovery to go more smoothly by being as healthy as possible before your surgery and making sure you are well-informed about what to expect during your recovery. Follow your consultant's advice during your recovery and call the hospital if you have any questions or concerns. Most people resume normal activities within a few weeks of closure of loop colostomy.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about closure of loop colostomy, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

1. Reversal: Colostomy, NHS
2. Considerations in Stoma Reversal, PubMed
3. Stoma Reversal, Colostomy UK
4. Reversal of a Temporary Stoma or Loop Ileostomy/ Loop Colostomy, NHS Royal Devon University Healthcare NHS Foundation Trust