Removal of Rectum 

So if you're having a removal of your rectum, the back passage, then you're likely to need a temporary stoma and that would be what we call a temporary ileostomy and that is there to protect the join when we rejoin the bowel back together having removed your tumour. The reason for that is that if the join were to fail and leak then you can develop serious complications complication needing further surgery and the ileostomy is there to make the operation safe and reduce the risk of these complications developing. Most patients tolerate and get used to having a temporary ileostomy and it is temporary and would be removed on average three months after the surgery but could be longer if you require any chemotherapy for further treatment of your tumour and that would depend on the results after the surgery. said most people may not like the ileostomy but get to tolerate it and are able to look after it themselves. Very rarely patients are unable to look after it and then relatives may be asked to help or in certain situations extra help at home from community stoma nurses, district nurses can help look after the stoma. But it is important the patient participates in the care of their stoma because if a problem develops such as the bag leaks it's very difficult then somebody may not be on hand to help look after the leak and help clear up and change the bag for you. The problems can occur when having an ileostomy, sometimes it may produce too much liquid in the initial period and occasionally patients may require Imodium to constipate them, may need some special drinks to help stop them getting dehydrated and may need to follow a certain diet, perhaps a low fiber diet so avoiding too much fruits and vegetables and then maybe eating some dry biscuits, crisps that may help form up the stool to reduce the output from the ileostomy and therefore avoid dehydration. Occasionally you may get a bit of bleeding from around the stoma this is often where the bowel is being stitched to the skin and this can be either settles down on its own and may need some further treatment as an outpatient just to cauterize the area using something called silver nitrate sticks. Because the temporary ileostomy is hopefully temporary in the vast majority of patients. The other complications of stomas are uncommon but they can sometimes include hernias so hernias can develop around the stoma. This may cause or show itself as a swelling around the stoma. Usually it doesn't cause any symptoms but sometimes it can cause discomfort and pain. Occasionally it may even cause the bag to not stick to the skin so the bag falls off and cause leakage. If that is the case then often that hernia will be dealt with when the stoma is reversed. If the stoma has to be used for longer term purposes or in some cases some people do have a permanent ileostomy then the hernia can be repaired if it causes problems but it's rare that we have to repair the hernias around the stoma. Sometimes the bowel can protrude through the stoma and we call it a prolapse. Again it's very rare this causes problems but sometimes if it's big enough it can push the bag off the skin and cause leakage issues. Occasionally people can get irritation of the skin around the stoma and that can cause soreness and pain but there are various strategies that we can use to minimize that risk and the important thing with any problem with the stoma you'll be in contact with a stoma nurse before the operation, after the operation in hospital and then you'll be followed up by the community stoma nurse from your area. So whether it's a patient from our hospital here or whether it's a stoma nurse based at our hospital here or whether it's a stoma nurse based at your local hospital, you'll be in contact, be put in contact with them on your discharge from hospital. The operation to reverse loop Pileostomy is a lot smaller than the the operation to remove the tumor. Usually the operation just means mobilizing the stoma from around the skin and the underlying muscle there and then joining both ends together which are on the skin and then it is just placed back inside the the abdominal cavity. Patients are usually in hospital for about two between two and four days depending on how long the bowel takes to get going and until you're eating and drinking normally. Again after the stoma is reversed sometimes you may have looser stool, you may have to go to the toilet with more urgency, but this will depend on exactly what operation you had when you required your iostamine, how low the join is, how close to the anus the join is, but this will be covered by your surgeon before your surgery. Many patients are very afraid of the thought of having a stone bag after surgery. The vast majority of patients are able to tolerate it and live a normal life. I have patients who go scuba diving and are very active and are able to manage a stoma bag so it has minimal interference with their normal lifestyle. It can take some time getting used to and it's very rare though patients reject it outright or unable to tolerate it. When it can be reversed obviously will help reverse this as soon as it's possible or it's the right thing to do in terms of your care but lots of patients have for different reasons permanent stomas that they're able to live with without any problems.