The Second Surgery

The second surgery to reverse the loop ileostomy is a much shorter operation with a more rapid recovery time. This is because the incision for the closure of the ileostomy is smaller—about two inches wide.

Following these tips and knowing what to expect can help you prepare for your second operation.

Toning Up
Usually, about four weeks after your initial surgery—when postoperative swelling has resolved—your medical team will encourage you to start to do exercises to improve the tone of your anal muscles. Strengthening these muscles will help you to regain control of your bowel function.

Anal Sphincter Toning Exercises

1. Tighten the anus as you would when trying to hold back a bowel movement.



2. Hold for a count of ten (10) and repeat five (5) times.



3. Repeat this exercise four times daily.

Do not be discouraged if you can only tighten your anal muscles for a count of five at first. You will slowly be able to reach the count of ten.

Do not overdo this exercise. Too much exercise can tire the muscle and keep it from working well.

The Second Operation
The procedure to reverse your temporary ileostomy is much easier on your body than the first operation because of the smaller incision.

Do not be alarmed if your surgeon tells you that he or she had to reopen the first incision to clear out some scar tissue. It is common for scar tissue to form in the bowel as part of the healing process. Removing the scar tissue will help ensure that the intestine is able to function properly.

You can expect to be in the hospital for about three or four days.

Preparation
Though you will not have to take a bowel cleansing preparation before the second surgery, you will have to begin a clear liquid diet (i.e., chicken broth, popsicles, and tea) the day before your surgery.

Remember: Unless doctors have told you to take specific medicines, you should have nothing to eat or drink after midnight before your surgery—including chewing gum, mints, and hard candies.

Postoperative Recovery
You will receive pain medication after the surgery. However, it may be comforting to know that the pain will be milder this time.

As with the first operation, a bladder catheter (tube) will be inserted during surgery. It is usually removed the first or second day after surgery.

You will be given intravenous fluids until bowel function returns. Your first meal will be clear liquids. Gradually, you will advance to a regular diet.

Remember: The postoperative recovery time is shorter. Nevertheless, it's important to understand that life after ileal J-pouch anastomosis surgery is different. Try to be gentle with yourself—developing coping strategies takes considerable time and perseverance.