Stoma reversal
An operation to close a temporary stoma and rejoin the bowel, so waste can once again pass through the back passage.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Stoma reversal closes a temporary stoma and rejoins the bowel so you go to the toilet normally again.
- It is a real operation with its own risks; it is not simply 'undoing' the stoma.
- Bowel habit often takes weeks to months to settle, and a few people have lasting changes such as urgency or leakage.
- Not all temporary stomas are reversed — in many cases they become permanent for medical or personal reasons.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Lets waste pass through the back passage again, removing the need for a stoma bag
When the bowel below has not healed, is diseased, or cannot be safely rejoined.
You are monitored on a ward and helped to start moving. The team watches for the bowel waking up; eating and drinking is reintroduced gradually.
A named contact in the surgical team and clear written warning signs of a leak or infection.
You are monitored on a ward and helped to start moving. The team watches for the bowel waking up; eating and...
You go home once your bowel is working, you can eat and drink, and pain is controlled. Bowel motions may be...
The bowel slowly settles into a more regular pattern. Skin care around the back passage and avoiding heavy lifting...
Most people return to many normal activities and bowel habit continues to improve, though it may not be exactly as...
What is a stoma reversal?
A stoma reversal is an operation to close a temporary stoma (an ileostomy or a colostomy) and reconnect the bowel, so that waste passes through the back passage again instead of into a bag.
It is only possible when the bowel further down has healed, is healthy, and can be safely rejoined. Before a reversal, the team usually checks the bowel and the join with tests such as a camera test or a special X-ray.
A reversal is itself a real operation, not just 'switching the stoma off'. It has its own recovery and its own risks, and bowel habit can take weeks or months to settle afterwards. Some people have looser, more frequent or more urgent bowel movements for a time, and a few have longer-term changes.
Importantly, not every temporary stoma can be reversed. Whether reversal is right for you depends on healing, your general health, the original operation, and your own wishes.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Loop ileostomy reversal
Closing a loop ileostomy, often after the join it was protecting has healed. Usually a smaller operation than a complex reversal, though still significant.
Loop colostomy reversal
Closing a loop colostomy and rejoining the large bowel once the bowel below has healed or a blockage has been dealt with.
End stoma reversal (e.g. reversal of Hartmann's)
Rejoining the bowel after an end colostomy, such as after a Hartmann's operation. This is usually a bigger, more complex operation with higher risk.
Reversal with extra reconstruction
Some reversals involve more complex rejoining or repair, especially after difficult original surgery, infection or radiotherapy.
Preparing for your surgery
- Ask whether reversal is genuinely suitable for you, and what the alternative is if it is not.
- Expect tests before surgery to check the bowel and the join, such as a camera test or a contrast X-ray.
- Tell the team about all your medicines and supplements, and follow advice on which to stop or adjust.
- Stop smoking if you can, as it slows healing and raises the risk of complications.
- Plan support at home for several weeks, and arrange help with lifting and transport.
- Ask about likely changes in bowel habit afterwards and how these are managed.
- Discuss timing — reversal is often safer within a sensible window after the first operation, once you have recovered from it.
What happens
A stoma reversal is done under general anaesthetic. For a loop stoma, the surgeon usually works around the stoma itself, freeing the bowel and rejoining the two ends, then closing the opening. For an end stoma, a larger operation is often needed to find the other end of the bowel inside the tummy and rejoin it, sometimes by keyhole and sometimes open surgery.
The surgeon checks that the join (anastomosis) is healthy and not under tension. The skin where the stoma was is usually closed loosely or left to heal gradually to reduce infection.
Afterwards you are looked after on a ward. Eating and drinking is reintroduced as the bowel wakes up, and the team watches for the bowel starting to work again. Most people stay in hospital for a few days, sometimes longer.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- When the bowel below has not healed, is diseased, or cannot be safely rejoined.
- When the rectum and anus have been removed, so there is nothing to rejoin to.
- When someone is too unwell, or has poor expected bowel control, so reversal risks outweigh benefits.
- When a person, after discussion, prefers to keep their stoma rather than risk reversal.
Delay surgery if…
- You have not yet recovered well from the original operation.
- There is active infection, an unhealed join, or unstable health.
- Pre-reversal tests of the bowel and join have not been done or are abnormal.
- You may still need other treatment (such as chemotherapy) that affects the best timing.
Alternatives to discuss
- Keeping the stoma, which for many people works well long term.
- Waiting until you are fitter or the bowel has healed further before deciding.
- Treating bowel-control problems first, where these would make reversal unsatisfactory.
- Accepting a permanent stoma when reversal is not safe or unlikely to give good control.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Lets waste pass through the back passage again, removing the need for a stoma bag
- Can improve body image, confidence and daily routine for people who found the stoma hard
- Removes the ongoing work and cost of stoma care for those it suits
- Restores a more usual toilet routine once the bowel settles
- For many people, an important step back towards life before their illness or injury
Risks & complications
- Looser, more frequent or more urgent bowel movements while the bowel adjusts
- Sore skin around the back passage from frequent or loose stools
- Tiredness and a recovery period after abdominal surgery
- A slow start to the bowel working again after the operation (ileus)
- Wound infection where the stoma was, or in the tummy
- Bowel blockage from adhesions (internal scar tissue)
- Longer-term changes in bowel control, including urgency or some leakage
- A hernia at the old stoma site or in the wound later on
- A leak from the rejoined bowel (anastomotic leak), which can be serious and may need further surgery or a new stoma
- Severe infection inside the tummy
- Damage to nearby organs during the operation
- Blood clots in the legs or lungs, and other serious complications that can rarely be life-threatening
The biggest specific worry after reversal is a leak from the rejoined bowel, which can be serious. Bowel control may also take time to settle, and some people have lasting urgency or leakage — this matters most when the original surgery involved the rectum. Ask your surgeon about your personal risk, the chance of needing a stoma again, and what bowel habit to expect afterwards.
Published figures to discuss
Reversal outcomes vary with the type of stoma, why it was formed, how long it has been in place, and the person's health. Complications after reversal are not rare, and timing appears to matter: reversal done too late after the original surgery may carry more risk. Figures below come from surgical series and should be read as cautious guides, not promises.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Any complication within 30 days of reversal | Around half of patients in one multi-centre emergency-stoma series (52%) | Includes minor problems; serious complications were less common. Varies by stoma type and case mix. | Risk factors for complications following intestinal stoma reversal — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Major (serious) complication after reversal | Roughly the high-single to mid-double-digit percent range depending on timing in one series | Reversal within about 18 months had fewer major complications (around 8%) than later reversal (around 35%) in that study. | Risk factors for complications following intestinal stoma reversal — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Temporary stoma never reversed | A large share in emergency cases; only about 29% were reversed in one UK series | Reasons include patient choice, frailty, dementia and the bowel not being suitable; planned (elective) stomas are reversed more often. | Risk factors for complications following intestinal stoma reversal — PMCpmc.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery involves both healing from the operation and the bowel relearning how to work after months of being diverted. It is normal for bowel habit to be unsettled at first.
- Frequent, loose or urgent bowel motions in the first days and weeks
- Sore skin around the back passage, helped by barrier creams and gentle care
- Tiredness for several weeks after surgery
- A gradual return towards a more settled bowel pattern
- Needing to learn your new 'normal', which may differ from before the stoma
Aftercare
- Follow advice on diet and fluids to help the bowel settle and avoid dehydration if motions are loose.
- Use barrier creams and gentle cleaning to protect the skin around the back passage.
- Avoid heavy lifting and straining in the early weeks to protect the wound and reduce hernia risk.
- Take any prescribed medicines, including those to firm up or regulate bowel motions if advised.
- Watch for warning signs of a leak or infection and seek help early.
- Attend follow-up appointments so healing and bowel function can be checked.
- Ask for help if bowel control problems are not improving, as there are treatments and therapies that can help.
- Pre-reversal tests of the bowel and join arranged
- Barrier cream and gentle wipes ready for sore skin
- Help arranged at home for lifting and chores for several weeks
- Easy access to a toilet planned for the first weeks
- A plan for managing loose or frequent motions
- Surgical team and out-of-hours contact numbers saved
- Clear warning signs of a leak or infection written down
Scars and how they heal
The old stoma site usually leaves a round scar, which can take time to heal and is sometimes left open to close gradually. You may also have keyhole scars or a longer scar from the tummy, depending on the operation. Scars usually fade over months.
⚠ Get urgent help if…
- Worsening tummy pain, a swollen tight tummy, fever or feeling very unwell (possible leak or infection)
- Vomiting, no bowel motions and cramping (possible blockage)
- Heavy bleeding from the back passage
- A hot, red, spreading area or pus at any wound
- Being unable to keep fluids down, or signs of dehydration with very loose motions
- Severe, uncontrolled urgency or leakage of stool that is not settling
- Calf pain, swelling, chest pain or breathlessness (possible clot)
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a healed, working join, no need for a bag, and a bowel habit you can manage. For many people this is achieved, but it can take time, and the result is not always exactly the same as life before the stoma.
Reversal cannot guarantee perfect bowel control, especially if the rectum was removed or treated with radiotherapy. A small number of people need a stoma again if the join fails or control is very poor.
For most people a successful reversal is lasting. However, bowel habit may continue to change for months, and some people have long-term urgency, frequency or leakage that needs ongoing management. Rarely, problems with the join or poor bowel control lead to a new stoma being formed.
Combining with other procedures
Reversal is sometimes combined with repair of a hernia at the old stoma site or other planned surgery. The timing of reversal is also weighed against any further treatment you may need, such as chemotherapy after cancer surgery.
Follow-up & long-term care
You will usually be reviewed by the surgical team after reversal to check healing and how your bowel is working. If bowel control is a problem, you may be referred for specialist advice, pelvic floor physiotherapy or other treatments. Tell your team early if things are not settling.
- Dietary and fluid adjustments to keep bowel motions manageable
- Skin care around the back passage while motions are loose or frequent
- Pelvic floor exercises or physiotherapy if bowel control is affected
- Review of any medicines used to regulate the bowel
- Follow-up for the join and, where relevant, the original condition
Revision and secondary surgery reality
- Reversal may have to be abandoned at operation if the bowel is too stuck down or unsafe to rejoin.
- If the join leaks or bowel control is very poor, a new stoma may be needed.
- Bowel habit may need ongoing management for months, and is not guaranteed to return to how it was.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A named contact in the surgical team and clear written warning signs of a leak or infection.
- Practical advice on diet, skin care and managing loose or frequent motions early on.
- A plan to assess and treat bowel-control problems, including referral for physiotherapy if needed.
- Follow-up that checks both the join and how you are coping, with support if a stoma is needed again.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is a loop reversal or a more complex end-stoma reversal
- Surgeon and assistant fees and the anaesthetic
- Theatre and facility costs, and whether keyhole or open surgery is used
- Pre-reversal tests such as a camera test or contrast X-ray
- Length of hospital stay, which varies with recovery and complications
- Follow-up appointments and treatment of any complications, including bowel-control problems
- The surgeon's and anaesthetist's fees
- Pre-reversal tests of the bowel and join
- Theatre, hospital stay and facility costs, with an estimate of the likely length of stay
- Follow-up appointments
- What happens, and what it costs, if a leak, complication or longer stay occurs
- Whether treatment for ongoing bowel-control problems is included or referred on
- What happens if reversal turns out not to be possible at operation
On the NHS? Stoma reversal is commonly carried out on the NHS when it is clinically suitable; private care is mainly used for choice of surgeon or faster access, but suitability for reversal is a clinical decision.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Describing reversal as simply 'switching off' the stoma rather than a real operation with its own risks.
- Not warning that bowel control may be poor or unsettled, especially after rectal surgery.
- No discussion of the chance that reversal cannot be done, or that a new stoma might be needed.
- Failing to explain the leak risk and what would happen if it occurred.
Marketing red flags
- Promising a guaranteed return to 'normal' bowels after reversal.
- Glossing over the chance of needing a stoma again or of lasting bowel-control problems.
- Treating reversal timing as unimportant.
- Not mentioning that many temporary stomas are never reversed.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Is reversal genuinely suitable for me, and what tests will you do to check the bowel first?
- How likely is reversal to give me good bowel control, given my original operation?
- What is my chance of a leak, and of needing a stoma again?
- What bowel habit should I expect afterwards, and how will it be managed?
- What is the best timing for my reversal, and why?
- Who do I contact, and how, if I have problems after the operation?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can every stoma be reversed?
Will my bowels work normally straight away?
When can a temporary stoma be reversed?
What is the main risk of reversal?
Could I end up with a stoma again?
Is reversal done on the NHS or privately?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: North Bristol NHS Trust — Reversal of stoma (ileostomy or colostomy) NHS — Colostomy (reversal) Colostomy UK — Support for people with a stoma Stoma reversal after emergency stoma formation — timing study (PMC) Risk factors for complications following intestinal stoma reversal — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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