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Had resection of rectum for diverticulitis with temporary ileostomy. Concerned about fecal incontinence after reversal of ileostomy

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Internal Medicine Specialist
Practicing since : 2000
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Hello
I am now 6 weeks post low anterior resection of rectum for diverticulitis/vaginal fistula, with temporary ileostomy. I will be having a contrast Xray next week to check healing of the anastomosis.
Apart from tiredness and a frequent feeling of rectal pressure making me want to have a bowel motion (but of course unable to), Im progressing reasonably well and now getting some energy back. I have read a lot about reversal of ileostomy and the incidence of faecal incontinence, so Im quite concerned about this happening should I have a reversal of the ileostomy. During surgery, half of my rectum was removed (because of the fistula and diverticulitis) and the sigmoid colon was pulled down to make an anastomosis.My surgeon told me I should not be incontinent but may have urgency,but in the light of what I have read, I would value your advice.
Thank you XXXXXXX Cowan
Posted Tue, 21 Aug 2012 in Digestion and Bowels
 
 
Answered by Dr. Sudhir 28 minutes later
Hello,

Thanks for the question.

If surgery didn't involve your anal sphincters, then there are good a chance that you won’t have incontinence. Incontinence is commonly see after surgeries were sphincters were also operated upon.

So depending on this you can decide about ileostomy closure.

But removal of half of the rectum would surely reduce your rectal capacity and symptoms like urgency can be there.

Hope this answers your question.

Please ask if there are doubts.

Regards.
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