Recovery: Long Term Healing Process

Oh, the relief of a bidet! Right after surgery, when your bowel is ACTIVE, you’ll find yourself wiping, and wiping, and wiping, and wiping, and wiping again. Your backside can be incredibly sore, and wiping with tissue one more time seems impossible.

A bidet can provide incredible relief. Getting clean with a stream of water (cold or warm will do) instead of what feels like fine-grit sandpaper is a huge advantage.

See our Shopping page for suggestions on bidets at various price points.

Many patients wonder whether their bowel function will ever feel “normal” again after ostomy reversal surgery. The answer varies from person to person, but in many cases bowel habits do improve significantly over time. After the intestine has been surgically reconnected through an anastomosis, the digestive system needs time to adjust to its new function. During the early recovery period, it is common to experience frequent bowel movements, urgency, or loose stools.

For most patients, these symptoms gradually improve as the bowel adapts. The colon and rectum begin to regain their ability to absorb water and regulate stool passage. This process may take several weeks or even several months. Factors such as the type of surgery performed, how much bowel remains, and overall health can influence recovery.

While bowel habits may not return to exactly the same pattern as before surgery, many people find that with time, diet adjustments, and guidance from their healthcare team, bowel function becomes manageable and predictable again. They find a ‘new normal’.

Resource: Lifetime Surgical, ‘Will I Ever Be Normal Again? The Truth About Colostomy Reversal’

Please seek the advice of your physician for your particular circumstances.

Estimate – 4 to 8 weeks

Resource: https://www.ostomy.org/intimacy-after-ostomy-surgery/

While it’s important to be hyper aware of your abdomen at all times, exercise is critical during all stages of healing.

In the hospital, walking right away – as soon as you feel comfortable doing so – is wonderful to get your bowels moving.

Continue walking and do light activity when you get home.

When can you start exercising in earnest? This is absolutely a discussion for your surgeon. If you were an athlete with strong abdominal muscles, you will likely be cleared to exercise much earlier than someone who was in poor physical condition before surgery. The bottom line is that your surgical opening must be healed well before resuming exercises that use your core muscles. Your biggest danger is a hernia, which can potentially strangulate your bowel as it protrudes through the opening in your abdominal wall.

Source: Hollister, ‘Exercising After Ostomy Surgery, 6 Common Questions

Exercise can play an important role in helping patients regain strength and overall health after ostomy reversal surgery. Once the bowel has been reconnected through an intestinal anastomosis, the body needs time to heal and adjust. Gentle physical activity supports circulation, improves energy levels, and helps restore muscle strength that may have declined during illness or recovery from surgery.

In the early stages of recovery, light activities such as walking are often recommended. Walking helps stimulate the digestive system, reduce the risk of blood clots, and improve bowel motility. As healing progresses, patients may gradually introduce low-impact exercises such as stretching, yoga, or light resistance training, always following their doctor’s guidance.

Exercise can also strengthen the core and pelvic floor muscles, which support bowel control and abdominal stability. However, heavy lifting should be avoided until the abdominal wall has fully healed to prevent complications such as a hernia.

With consistent, gradual activity, many patients regain endurance, confidence, and a stronger sense of well-being.

Speak with your doctor and follow their specific recommendations for your ‘returning to exercise’ schedule.

For most ostomy reversals, there is a risk of hernia at the surgical site. Your stoma was created by severing the muscles in your abdominal wall, and that opening may represent a long-term weak spot.

As a result, most surgeons recommend lifting items with any weight very carefully. The rough schedule is:

• Nothing heavier than say a gallon of milk immediately after surgery.
• After the first few weeks, lift nothing heavier than 5 to 10 pounds for 6-8 weeks.
• Long term, nothing more than about 25 pounds.

Some surgeons may lift all restrictions. Your particular anatomy and the type of surgery that you had will greatly impact your long-term instructions.

The primary concern is pressure in the abdomen caused by pushing, pulling, twisting, or abdominal exercise. This pressure can create outward pressure on the abdominal wall, and potentially create a hernia. A hernia is an opening through which the bowel can protrude – this is immensely dangerous, as the bowel can be ‘strangled’, a high-level emergency.

Consider utilizing an abdominal support garment after surgery, and as long as it makes your body feel more comfortable.

Resource: University of Washington Medical Center, ‘Activity After Ostomy Surgery’ (Guidelines and self-care)

‘Bowel function’ is an incredibly complex topic. Having full control of one’s bowels is the result of many factors, including:

• The health of the bowel/gut.
• The resulting anatomy after treatment, radiation or surgery, i.e. whether the sigmoid, rectum and/or full bowel are present, and the strength of the sphincters.
• Whether or not the patient had chemo or other treatments that impacted the gut biome.
• The strength of the muscles that make up the pelvic floor.

When there is a deficit in one of these elements, building the strength of the pelvic floor can help to compensate.

See our page, ‘Pelvic Floor Therapy‘ for details on how this form of physical therapy may be of benefit.

A hernia occurs when an internal organ or tissue pushes through a weakened area in the surrounding muscle or connective tissue. One of the most common signs of a hernia is a visible bulge or lump, often in the abdomen or groin area. This bulge may become more noticeable when standing, coughing, or straining, and it may disappear when lying down.

Many people experience discomfort, pressure, or a dull ache at the site of the bulge, especially after lifting heavy objects, bending, or prolonged standing. Some hernias can cause a burning or aching sensation. In certain cases, individuals may feel weakness or heaviness in the abdomen or groin. If the hernia becomes trapped (incarcerated) or the blood supply is cut off (strangulated), symptoms can worsen and may include severe pain, nausea, vomiting, and redness around the bulge. These symptoms require immediate medical attention. Early recognition helps prevent complications and allows for timely treatment.

Resource: Johns Hopkins University – How to Tell If You Have a Hernia

Changes in weight are common after ostomy reversal surgery, and patients may experience either weight loss or weight gain during the recovery period. Because the bowel has been surgically reconnected through an intestinal anastomosis, the digestive system often needs time to adjust to normal digestion and nutrient absorption.

In the early weeks after surgery, some people lose weight due to reduced appetite, temporary dietary restrictions, or frequent bowel movements that make it difficult for the body to absorb nutrients efficiently.

As recovery progresses and bowel function stabilizes, many patients gradually regain lost weight. In some cases, people may even gain weight once they are able to eat a wider variety of foods and their appetite returns, and as their bowels are not moving as quickly through an active stoma (leading to increased nutrient absorption). Changes in activity level during recovery can also influence weight.

Maintaining a balanced diet with adequate protein, healthy carbohydrates, and fluids can support healing and energy levels. If weight loss becomes significant or persistent, it is important to discuss nutritional support with a healthcare provider or dietitian.

After ostomy reversal surgery, many patients notice that certain foods can trigger digestive symptoms while the bowel is adjusting. Because the intestine has been reconnected through an intestinal anastomosis, the digestive system may be more sensitive for several weeks or months. During this time, some foods can increase bowel activity, leading to loose stools, urgency, gas, or abdominal discomfort.

Common food triggers may include spicy foods, high-fat or fried foods, caffeine, alcohol, and highly processed snacks. Foods that produce gas—such as beans, onions, cabbage, and carbonated beverages—can also cause bloating or discomfort in some patients. Dairy products may trigger symptoms for people who develop temporary lactose intolerance after surgery.

Each person’s digestive response is different, so it can be helpful to keep a food diary to identify personal triggers. Many healthcare providers recommend starting with a simple, balanced diet and gradually reintroducing foods one at a time to determine which foods are well tolerated. A food will be perfectly fine for one patient, but have a volatile impact on others. We each need to find out for ourselves what works, and what does not.

Resource: VinMec Healthcare System, ’10 Foods to Avoid After Bowel Resection Surgery’

Improving the gut microbiome after ostomy reversal surgery can play an important role in digestive recovery and overall bowel health. During the time a person has an ostomy, changes in diet, medications such as antibiotics, and altered intestinal flow can affect the balance of beneficial bacteria in the digestive system. After the bowel is reconnected through an intestinal anastomosis, the gut gradually begins to rebuild a more stable microbial environment.

One helpful approach is reintroducing fiber-rich foods slowly, as tolerated. Foods such as oats, bananas, cooked vegetables, and whole grains can support the growth of healthy gut bacteria. Probiotic foods like yogurt with live cultures, kefir, sauerkraut, and other fermented foods may also help restore microbial balance.

Equally important are prebiotic foods, including garlic, onions, and asparagus, which provide nourishment for beneficial bacteria. (They provide support so that the healthy flora grow in the gut).

Staying well hydrated and maintaining a balanced diet supports digestive healing. As the microbiome stabilizes, many patients notice improved stool consistency and more predictable bowel function.

PreBiotics vs. ProBiotics

Prebiotics and probiotics both support gut health but serve different roles in the digestive system. Probiotics are beneficial live microorganisms—often found in foods like yogurt, kefir, and fermented vegetables—that help maintain a healthy balance of gut bacteria. Prebiotics, on the other hand, are types of dietary fiber that feed and stimulate the growth of these beneficial bacteria. Foods rich in prebiotics include garlic, onions, bananas, asparagus, and whole grains. Together, they work to support a healthier gut microbiome.

Regulating bowel function after ostomy reversal surgery is an important part of long-term recovery. When the bowel is reconnected through an intestinal anastomosis, the digestive system often needs time to adapt. During this adjustment period, patients may experience frequent bowel movements, urgency, loose stools, or irregular patterns as the colon and rectum relearn how to store and pass stool effectively.

Several strategies can help support bowel regulation. Dietary adjustments are often the first step. Eating smaller, more frequent meals and gradually reintroducing fiber can help stabilize stool consistency. Some foods—such as caffeine, spicy foods, or high-fat meals—may temporarily increase bowel activity and may need to be limited early in recovery.

Staying well hydrated is also important, especially for patients who previously had an ileostomy, as fluid absorption may take time to normalize. In some cases, physicians may recommend medications such as antidiarrheal agents to slow bowel activity. Over time, with patience and careful management, bowel habits often become more predictable and manageable.

IMPORTANT! Do not take anything to regulate your bowel (to slow it down or speed it up) without speaking with your surgeon, especially in the days immediately following your surgery. 

GLP-1 Receptor Agonists and Bowel Slowing

Some patients with LARS (Lower Anterior Resection Syndrome) have had success with taking GLP-1 medications like Ozempic, Wegovy, Mounjaro. One of their primary side effects is motility slowdown, delayed gastric emptying and reduced intestinal contractions. While this can be an issue for some ‘normal bowel’ patients, for someone with a highly active bowel due to LARS, this side effect can be a gift.

Speak with your doctor about the possibility of using this class of drugs if you have significant issues with bowel control. This is not an endorsement of this approach, merely a presentation of the success that some patients are having with these medications.

TAI (TransAnal Irrigation)

Some people choose to irrigate their bowels regularly for a colonic effect. They control when/where they defecate by flushing out the contents of the bowel using a medical kit built expressly for this purpose.

See our page, ‘Let’s Talk About 💩Baby!‘ on this website.

Lower Anterior Resection Syndrome (LARS) is a group of bowel symptoms that can occur after surgery involving removal of part of the rectum, most commonly following a low anterior resection for rectal cancer or other diseases. This surgery reconnects the colon to the remaining rectum or anus through an anastomosis, which can affect the normal function of the bowel and its ability to store stool.

People with LARS may experience symptoms such as frequent bowel movements, urgency, difficulty controlling gas or stool (fecal incontinence), clustering of bowel movements within a short period of time, and a feeling of incomplete emptying. These symptoms occur because the rectum—which normally acts as a storage reservoir—may be smaller or less effective after surgery.

The severity of LARS varies widely. Some patients experience mild symptoms that improve over time, while others may need dietary changes, medications, pelvic floor therapy, or other treatments to help manage bowel function and improve quality of life.

Excellent patient support Facebook page: Living with Low Anterior Resection Syndrome

• This group is private, so send a request to join. Be sure to answer all questions on the join request.

See our ‘Lower Anterior Resection Syndrome?‘ page on this website.

Getting back to feeling like yourself after ostomy reversal surgery can take time, patience, and gradual adjustment. While the surgery reconnects the bowel and removes the need for an ostomy appliance, your body still needs time to recover from the procedure and adapt to its new digestive routine.

In the weeks and months following surgery, you may experience changes in bowel habits, energy levels, and appetite as your system continues to heal.

Emotionally, the transition can also bring a mix of feelings. Many people feel relief and excitement about moving forward after living with an ostomy, while others may feel uncertain as they learn how their body responds after the intestinal anastomosis. This adjustment period is completely normal.

Small steps can help rebuild confidence. Gradually returning to daily activities, exercising lightly, and maintaining a balanced diet can support both physical and emotional recovery. With time, most patients regain strength, develop predictable routines, and rediscover a sense of normalcy in their everyday lives.

Resource: Trio Ostomy Care, ‘Recovering from Stoma Reversal Surgery: What to Expect’

While many patients look forward to ostomy reversal surgery, some people find that the experience does not meet their expectations. After the bowel is reconnected through an intestinal anastomosis, it can take time for digestion and bowel function to stabilize. In some cases, patients may experience ongoing and unalleviated symptoms such as frequent bowel movements, urgency, incontinence, or abdominal discomfort. These challenges can affect daily routines, sleep, and overall quality of life.

For individuals who had adapted well to life with an ostomy, the adjustment back to natural bowel function may feel more difficult than anticipated. Some people may even feel frustrated or disappointed if symptoms persist longer than expected.

It is important to remember that recovery timelines vary widely. Discussing symptoms with your surgeon or gastroenterologist can help identify treatments, dietary strategies, or pelvic floor therapy that may improve bowel control.

In rare cases, some patients choose to return to a permanent ostomy if it provides a better quality of life. This decision is typically made after a significant amount of time has passed after the ostomy reversal, as healing and a return to normal bowel function takes time.

See the page, ‘Lower Anterior Resection Syndrome‘ on this website.

Resources:

There are many Reddit and other site discussion on this topic.

Survivor Jelena offers a great video on this topic.