Temporary stoma – a step on the road to recovery

When people hear the word “stoma,” many initially think of a permanent change. However, in many cases, a stoma is only temporary – a medically necessary interim solution that allows the body time to heal.

A temporary stoma can be stressful, both physically and emotionally. And yet it serves a clear purpose: it protects, relieves pressure, and creates space for recovery. In this article, we explain what a temporary stoma is, when it becomes necessary, and what the path back to normal bowel function can look like.

What is a temporary stoma?

A stoma is an artificial opening through which the intestine or ureter is brought out through the abdominal wall. This allows stool or urine to be collected in a pouch.

In contrast to a permanent stoma, which remains in place indefinitely, a temporary stoma is only created for a specific period of time. It serves to relieve the affected section of the intestine – for example, after surgery or in the case of acute inflammation.

Permanent or temporary stoma?

This decision depends heavily on your underlying condition and will usually be discussed with you in detail before the operation. Your surgeon will explain this to you and will be able to tell you in advance whether your stoma can be reversed or not. For example, it may depend on whether your intestine is permanently damaged or simply needs a break. The decision itself will be made by your treating physician.

Does every type of stoma have to be temporary?

No – a urostomy, for example, is always a permanent stoma. However, colostomies (large intestine) and ileostomies (small intestine) can be reversed under certain circumstances.

When is a temporary stoma created?

A temporary stoma is used in various situations, for example:

• After intestinal surgery
• In case of inflammatory bowel diseases (e.g., Crohn's disease or ulcerative colitis)
• To treat intestinal perforations or abscesses
• After an intestinal obstruction
• colorectal cancer
• Wounds or fistulas in the perineal area
• Birth defects such as a blocked or missing anal opening (known as imperforate anus)

The aim: The bowel function should be restored naturally later on.

How long does a temporary stoma remain in place?

The duration of wear depends greatly on the individual case – usually several weeks to months. The decisive factor is whether the intestine has recovered sufficiently, inflammation has subsided, and the surgical sutures on the deactivated part of the intestine have healed stably. The reversal is usually performed through a second procedure – in many cases, minimally invasive.

Stoma reversal surgery: relocation of the stoma

What is stoma reversal surgery?

Stoma reversal surgery is a surgical procedure in which the section of intestine that has been moved to the abdominal wall is detached and returned to its original position in the intestinal tract – in principle, the reversal of a colostomy or ileostomy.

When can a stoma be reversed?

A temporary stoma can be reversed after a few weeks to months, once the intestine has had sufficient time to heal and recover.

If the stoma was created as part of colon cancer treatment, reversal usually only takes place after chemotherapy has been completed. Afterwards, the body – especially the intestine – needs sufficient time to recover. In most cases, a period of up to six weeks after the end of treatment is planned before a decision is made about reversal surgery.

If a stoma reversal is an option for you, it is best to talk to your surgeon. They can advise you in detail about the medical options and next steps. If a reversal is not an option for you, that is also a perfectly legitimate decision. Especially in the case of a temporary stoma, you have the option of deciding for yourself whether you want to keep the stoma, provided there are no medical reasons against it. For some people, a stoma not only means restrictions, but also an improvement in quality of life, security, and freedom – especially if they previously experienced many complaints or uncertainties.

Requirements for relocation

The initial decision regarding a possible reversal is made by your attending physician. They will assess whether the procedure is medically feasible, what individual risks exist, and how well your bowel function is likely to recover. The following requirements must also be met:

• The sphincter muscle was preserved and is functional
• The affected section of the intestine was successfully relieved and is intact
• Any inflammation of the intestinal areas has completely healed
• Chemotherapy or radiation therapy is not (immediately) necessary

Importance of sphincter muscle training

One aspect that is often neglected in temporary stoma care is targeted training of the sphincter muscles. While the stoma is functioning, the natural bowel reflex is switched off – the sphincter muscles and pelvic floor are largely inactive during this time. Without targeted training, difficulties may arise after reversal, such as:

• Fecal urgency or fecal incontinence
• Frequent bowel movements (low anterior resection syndrome, LARS)
• Uncontrolled emptying

It is therefore recommended to start training the sphincter muscles early on after the stoma has been created – ideally several times a day by consciously tensing and relaxing the muscle. This can help to maintain function and optimally prepare for subsequent reversal.

A so-called Biofeedback-Training can be used for support. A special device is inserted rectally to measure muscle strength when tensing. This allows training progress to be objectively observed and specifically promoted. You should discuss with your doctor whether this method is suitable for you. Some clinics or specialized physical therapy practices offer Biofeedback-Training directly on site.

Physiotherapists specializing in pelvic floor training or continence advisors can also provide valuable support in preparing for the transfer back. The aim is to strengthen muscular control at an early stage in order to restore continence as quickly and reliably as possible after the transfer back.

After relocation

Every operation involves a significant intervention in your body. Therefore, give yourself enough time to get used to the new situation and recover in peace. As a rule, you can be released from the hospital after about 3 to 5 days, depending on your individual healing process and well-being.

Nutrition

After a reversal, hospitals often recommend that you initially eat easily digestible liquid foods so as not to put unnecessary strain on the intestines. A high-fiber diet is then gradually recommended to support natural bowel function.

It's important to remember that: Listen to your body. Eat what you tolerate well and what feels right for you.

Nevertheless, you should ensure that you have a balanced diet and drink enough fluids, around 2 to 2.5 liters per day, as both are crucial for regeneration and building healthy gut flora.

You should avoid the following foods if possible:

• Citrus fruits (oranges, lemons, grapefruits, etc.)
• Foods that cause flatulence (broccoli, beans, cabbage, onions)
• Hot spices
• Carbonated and alcoholic beverages

Exercise

Regular exercise is helpful for gently stimulating bowel activity. Even short walks or light exercises can be enough to activate the digestive tract. However, avoid heavy lifting or physically strenuous activities – your body needs time to heal. Gentle exercise not only supports normal bowel function, but also promotes your overall recovery after the procedure.

Please note: After surgery, the intestine is usually not yet fully functional. It can take several weeks to months for it to return to normal activity. Approach this process with calm and patience – your body needs time to adjust. If you have any questions or concerns, your treating physician is always available to advise you.

Problems and complications

The reversal of the stoma is usually a relatively straightforward surgical procedure. However, the body needs time to adjust to the changed situation afterwards. In most cases, healing proceeds without major complications. Nevertheless, the adjustment phase can be experienced very differently from person to person – for some patients it is completely unproblematic, while for others it may be temporarily associated with discomfort or pain. Good post-operative care and open communication with the treatment team are particularly important during this phase.

Ileus (intestinal obstruction)
After intestinal surgery, the intestines may initially function sluggishly. In some cases, a blockage (ileus) may occur, disrupting the transport of intestinal contents, either partially or completely. This can be caused, for example, by adhesions of scar tissue, which lead to a narrowing of the intestinal lumen (the inner space of the intestine). Typical symptoms of ileus include abdominal pain, nausea, vomiting and a feeling of fullness due to the backlog in the intestine. Depending on its severity, this condition may be temporary or require specific medical treatment.

Anastomotic leak
An anastomotic leak refers to a leak at the junction of the repositioned intestine. Intestinal contents leak out because the connection between the sections of the intestine – the so-called anastomosis – is not completely sealed. The causes of a leak can vary. It is often due to insufficient wound healing, in which the tissue does not close the suture securely enough. Infectious processes or mechanical pressure on the suture site can also lead to leakage. Rarely, a technical cause, such as an incorrectly placed suture, is responsible. An anastomotic leak can manifest itself through fever, abdominal pain, circulatory problems, or delayed recovery after surgery. In some cases, a leak requires further surgical intervention. In this case, a temporary stoma is often created again to relieve the intestinal connection and support healing.

Urinary and sexual dysfunction
These symptoms are usually temporary and disappear completely over time. The risk of urinary and sexual dysfunction may be increased when a terminal colostomy is reversed. This is because the nerves that control bladder and sexual function are located in close proximity to the original stoma site and may be affected by the procedure.

General pain
A wound usually causes pain, especially during the healing process. However, if the pain persists for a long period of time or worsens, this may indicate an infection. In this case, it is important to contact your doctor immediately to determine the cause.

Skin care

After the reversal, a wound remains at the site of the former stoma, which will scar over time. Be sure to keep the wound clean and dry to prevent infection. During the healing phase, avoid using perfumed soaps, lotions, or creams, as these can irritate the skin and impair wound healing. Once the wound has completely healed, you can resume your individual skin care routine, tailored to your skin type and personal needs.

Medical devices and aids for all types of stoma

We understand that ostomy care is diverse and unique. It is therefore our fundamental goal to offer you the best possible support with our high-quality STOMOCUR® products.

Discover our wide range of ostomy care products for every type of stoma – colostomy, ileostomy and urostomy. In addition, our product range includes a variety of special supply products for specific needs.

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