Hartmann’s reversal?

[Frenchhouse3]

Has anyone had a Hartmann’s reversal at all and how did they find it?

I would like my stoma reversed in around ten months, all being well.

Thank you

Denise

[Meridian14]

Hi Denise, as you know, like you i'm hoping for a reversal in about a year - all being well.

I have a Hartmann's End.

I was told by my surgeon that for my reversal it would need a two part operation.

He said that I would have to have a temporary ileostomy (another stoma created in my ileum/small intestine), I don't know whether that would be a loop ileostomy or end ileostomy, I'm guessing I would need to have that to allow the Colostomy reversal to heal before it can be used.

I can't say that I have heard anyone on this forum saying that they have had this 'two part' surgery. And I'm not saying that your reversal will also be a two part procedure.

I was told this by my surgeon who did my debulking, he did a fantastic job, but for reversal, and fixing of parastomal hernia, he said he would have to work with a bowel surgeon to carry out this work. I have not checked with the bowel surgeon whether or not it would indeed be a two part procedure, but I certainly have many questions for him/her.

Do you have a hernia? My surgeon mentioned the use of mesh to fix it when reversal takes place. Again, I have many questions about this as I know the use of some mesh has been known to cause some problems, but maybe that's more so with hernia fixes on continuing stomas as opposed to the closing (reversal) of stomas, and of course there are different types of mesh, synthetic as well as biological, although not sure NHS would use biological as it's very expensive.

Thought i'd mention it.

Best wishes

Lisa

[Frenchhouse3 in reply to Meridian14]

Hi Lisa, I only found out today that mine is a Hartmann’s and my stoma nurse did mention it may have to be done in two parts, that’s why I thought I’d ask if anyone has had the reversal yet. It sounds a bit scary tbh but I really do want it done. I still get urges for a poo that my be psychological ( like when a person loses a limb and still perceives pain) . I hate it when this happens as it feels out of my control, if that makes sense?

Would it put you off having a two part procedure or not?

Thank you so much for answering though, as it does sound what you were told too, is right.

Love Denise xxxxx

Ps No hernia, so far 🤞

[Meridian14 in reply to Frenchhouse3]

I don't think a two part procedure would put me off. But like you, i would really want to hear some first hand experiences; success stories, difficulties etc, so that I can make an informed decision.

A woman who lives opposite me had an ileostomy many years ago. She had the ileostomy reversed after a few months and has never had any troubles with it.... so I would hope that having an ileostomy created to allow colostomy reversal to heal, then having the ileostomy reversed, would be okay in that the ileostomy would heal well and not give me trouble.

My logic tells me that because waste travelling through the ileum is in more of a liquid form, there would be minimal risk of blockage from tissue scarring after reversal surgery of the ileostomy, whereas by the time it gets to the large, lower intestine, its more formed and therefore more risk of blockage at the reversal site of the colostomy... although, my logic may be way off the mark on that. But i would be asking questions about these risks. I think ileostomys have less risk of herniating also.

You probably will have read that one of the women on this hub, Di i think her name is, is having a colonic dilation, presumably to try and stretch the scar tissue. I think she mentioned she was having some trouble with blockages before her reversal but continues to have some trouble after reversal. Also, I can't remember where her surgery was (what part of her intestine) and what type of stoma she had.

I also spoke with my stoma nurse a while back and the discussion with her brought up more questions; one being how much 'holding' capacity would i have (how much of my intestine was taken away) would i be visiting the toilet constantly? I would not expecting my toileting to be like it was before surgery, but how different would it be?

Have you registered with Colostomy UK? They have a magazine, Tidings, that they send out which always has many personal stories so it's an interesting read. They also have a stoma helpline: 0800 328 4257. you can receive experienced based advice and guidance from a volunteer, some whom have had stoma reversals (not necessarily caused from cancer). They have a support group on Facebook to, 'Colostomy UK support group' - I've not joined yet. I did speak with one volunteer who told me about her reversal, but it was an ileostomy reversal. I think I will call them again and ask if hey have any volunteers that have had reversal for the same surgery you and I had.

Are you wearing ostomy belts? I would advise you to do so... to avoid getting a hernia. Hernias are very common with colostomys and they are a real drag to have.... literally, it feels like my stoma area is being dragged. I wish someone had told me about the risk of stoma hernias. They only told me about the risk of a hernia from my main incision... i was being sooo careful, but had I have known about the risk of stoma hernias, I would have been wearing a support belt from the very beginning.

I mostly wear ostomy belts that have a hole to allow the stoma bag to pass through and allow stool to pass into the bag. Once I'm sure that I have mostly finished passing stool, I swap to a belt that holds everything snug (no hole in the belt). I have a number of different belts; from Suport-X, Comfizz, and my favourite ostomy belt (most comfortable) is Italian made, the brand is ORIONE, sold by Sports and Medical Bracing LTD. I found it on Amazon (I don't like using Amazon - but sometimes needs must).

If I find out any further info, or hear of any reversals of Harmanns end, or if you find out any further info, let's keep each other in the loop (no pun intended) haha!

Best

Lisa xx

.

[Frenchhouse3 in reply to Meridian14]

Hi Lisa, thank you so much for taking the time to give more information and advice. I will now order he belt as a preventative measure as I really want to avoid a hernia. I do have a couple if support vests but they’re really hard to get on and off, a belt sounds much simpler!

I am put off about having the ileostomy before reverting but would still do it too. I did have quite a lot of bowel removed and the surgeon who did this part of my op also said I would probably need the loo a lot more often but that doesn’t overly worry me. I just hate having these urges to poo and not be able to actually go. However, I know the operation saved my life and I’m more than grateful for that.

If I hear from any others who have had to reversal, I’ll make sure I let you know.

So glad to be able to talk with you and share our feelings and experiences of stomas.

Denise xxxxx

[Meridian14 in reply to Frenchhouse3]

ps, I also get those urges. It's totally normal but yes, it is very frustrating because it's so uncomfortable and like you say, it's totally out of your control in that you can't just get rid of it and get it out.

When I first had that urge soon after surgery, I was convinced that I had stool stuck in my bottom (in the stump) because I had the urge for days... about 4 days. I was at a clinic appointment and I was so convinced something was stuck there, that my surgeon offered to check. He put his glove on and had a bit of a (painful) root around - nothing there whatsoever! I was so confused.

My stoma nurse said if I sit in the toilet and relax, it sometimes relieves it. I find that if I do pelvic floor exercises when get those urges, sometimes that works for me - it relieves it.

xx

[Frenchhouse3 in reply to Meridian14]

Oh Lisa, thanks so much for this, that’s exactly how it is with me! I’m a bit fixated about it at the moment and I think it’s causing it to happen more! I must try and keep distracted.

I will try the pelvic exercises! My nurse said to sit in the loo also as it tricks the brain into thinking you’ve had a poo!

Also, she has suggested using a pessary in case there is a little bit of solidified mucus inside as this will help clear it. I’ve never actually seen any come out before and I’ve had the stoma for 14 months now.

How long have you had yours?

Denise xxxxx

[Meridian14 in reply to Frenchhouse3]

I had my surgery in June 2019... so our stomas are twins! (almost)

Yes, do try the Kegel exercise... they do tend to work for me, not immediately but definitely calms the urge.

xx

[Frenchhouse3 in reply to Meridian14]

Haha; yes! I have started already 🤞So glad I have someone to share notes with now!

Thank you so much!

Xxxxx

[Xande]

I had my Hartmans reversal about 3 years ago after I persevered with stoma for 18 months. Although surgeon said he couldn’t promise to fix it in one operation, he did. I was so happy to be able to poo in toilet, far less smelly and awkward than to go out and not be sure if there would be places for me to dispose of bag and clean myself properly. No regrets at all, I must admit when you need to go, you need to go straight way, no waiting half an hour. I did go to a physiotherapist for exercises to strengthen my muscles for 2 months before my operation. Please don’t think I wasn’t happy to have survived my original operations which included all my female parts, a slice off my liver, gall bladder, appendix, etc as well as part of my bowel. I feel blessed to live in an age that can attend to these problems. Good luck to you and take instruction only from your doctors. Best wishes from Australia.

[Frenchhouse3 in reply to Xande]

Hi Xande, thank you so much for your reply, it has really made my day. I hope to meet with the Colo- rectal surgeon soon to discuss this. I’m very anxious about it but would love to be able to poo naturally again!

Like yourself, I was extremely grateful to have it done during my op as it saved my life but to have it reversed now would be an extra bonus.

I’ll let you know how I get on.

Thank you so much again for getting in touch.

All the very best

Denise xxx