What to expect with takedown

Best thing I did was to read the advice on this site and also advice from my sister who has had her pouch for almost 30 years.  My own experience was not bad at all.  I prepared for surgery by being in good shape prior to it, getting essentials ahead of time, wipes, Calmoseptine butt cream, soft toilet and a bidet.  I brought the butt cream, wipes and toilet paper to the hospital with me.  I had surgery on Monday and was out by Thursday.  Had some nausea and throwing up and had to take potassium pills due to low levels.  I was off higher dose pain killers before leaving the hospital and took Tylenol extra strength at home. I had filled a prescription for Oxy prior to surgery, but never needed it.   All my surgeries were done laparoscopically.  I was out and about after being home for a little over a week.  However, everyone has different experiences, very individual.  I am now 6 mos. out, with anywhere fro 2-4 bm's a day and none at night.  I do have minor leakage here and there, but nothing I can't deal with.  Get up and walk as soon and as often as you can in the hospital and stick to the low residue diet in the beginning and gradually try new foods.  Have to say, I have increased my fresh fruit intake over the last month and things are good.  Hope that some of this helps.  You can read older posts with lots of good information from others on this forum as well.  Good luck!

Oh yeah, forgot about the gas.  Lots to begin with, but it gets better, and helps if you walk.  Now, ai hardly notice it unless I eat beans, broccoli or other types of gas producing foods.  Still, it isn't that bad!

Is the bidet really necessary? Couldn't I just pat my bottom with toilet paper or baby wipes instead of wiping ? And is the cream needed the same day as surgery ?  When do you need to use the cream and why?

I think I started there cream while in the hospital, maybe by the third day.  I like the bidet myself, it has helped me a lot.  There are other ideas, such as sitz baths, they have cheap ones, under $10.00. or spray bottles.  Just important to keep the area clean and dry.  I didn't have my bidet for the first 2 weeks, so used disposable cloths from the hospital and water, then patted it dry before applying the cream.  

I used wet wipe initially only because my Pouch Nurse said so; a day after surgery I did experience butt burn, which ilex Paste relieved within a couple of hours, I continued to apply the ilex for a couple of days; my pain turned out to be an anal fissure rather than the traditional diaper rash type butt burn, which I've never actually suffered from.

Other than the fissure, I've never endured any other pain associated with this kind of surgery.

I don't suffer from gas either and I certainly don't need or have ever used a bidet, more often than not I use regular everyday toilet paper, wiping as normal and only reverting to wet wipes if and when I've had reason to apply the ilex Paste or when cleaning up after leakage or an accident.

At the time, ilex Paste wasn't available in the UK and my Pouch Nurse provided samples sachets; I also had a tube of ilex which I'd been using to heal and protect the broken skin around my Stoma, I wasn't aware it could be used to treat and prevent butt burn or anal fissures.

I certainly wouldn't be without ilex Paste now, although I rarely need or use it; I've often say, it's best to have ilex Paste and not need it, than need it and not have it.

KC, I assume you've already had your J Pouch created, that's often the most difficult surgery to recover from, the takedown surgery is relatively easy.

I don't think takedown surgery will be performed laparoscopically as the loop ileostomy is on the surface of the abdomen and kind of requires stitching and pushed back into the abdomen.

After takedown I remained in hospital for  msybe 4 days and BMs were eventually down to 4 or 5 per day and maybe 1 or 2 during the night, by time I was ready to leave hospital, my night time BMs had stopped.

Currently, my BMs are never less than 2 per day and rarely more than 5, on average 3 or 4 per day, never any night time BMs or urgency, although I do experience soiling and leakage during the day, so always best to wear pads.

Applying the ilex before butt burn develops, is to protect the skin from the acidic output and it burning the skin, the ilex provides a barrier, I guess, also healing properties.

Yes, all three surgeries can be done laparoscopically, as mine was done.  You can actually see videos of the procedures from Cleveland Clinic, very interesting.  My surgeon went through the same incision site, where the stoma was,  for the final surgery.  The scar is only about 3/4 of an inch.  and as I recall there were about 6-8 steri strips covering it, that eventually came off.

This isn't related to takedown , but currently the area around my stoma hurts especially to touch, on the top area it is swollen and kinda bumpy from being inflamed and the bottom area is swollen and bloody and had kept spreading lower. It hurts to use the barrier wipe on the skin around the stoma. I don't know how to decrease the irritation. I even started using barrier rings because the alcohol paste burned so bad it was hell taking them off and putting them on how do I prevent this from getting bigger..

Not sure what to tell you about this.  I never really experienced any real irritation around the stoma area.  Did you have an ostomy nurse that you might be able to call?  Or maybe an ostomy nurse you can speak to at the hospital where you had surgery.  I noticed you had your original surgery in November and takedown soon.  That's great!  My surgeon had me wait 6 mos.between the first and second surgery and then an additional 8 weeks for the final one.  I actually waited 7 mos. because of a hiking trip we had planned on in May.  It was easy hiking with the bag, not sure what it will be like when we go again this May, now that I have a working j-pouch.

Luckily my surgeons only made me wait 6-8 weeks. I had My total colectomy in November, my rectum removed and pouch made December 30th and now my bag will be taken down the second week of march ! I don't know why your surgeon would make you wait that long tho! I'd rather get it all over with

It seems this is the way he does it.  For me it worked out well.  I was in much better shape for my last two surgeries.  Also, I had to take care of a frozen shoulder and tachycardia, so needed to have catheterization ablation for that as well.  Also, I had erythema nodosum, a skin issue going into my first surgery, so I was not in real good shape, could not even walk into the hospital due to swelling of ankles and knees.  I'm was also older going into surgery and we could afford to have me not working for a little while.  

Hello, KC23.

The takedown (or reversal) usually takes 45 minutes under general anaesthesia. Whatever skin irritation you have around your stoma now should be gone because they will simply open your stoma site a tiny bit, clean up any adhesions, push your intestine back inside, and close the hole with stitches or, as my surgeon did, by a "purse string" technique. There shouldn't be need for laparoscopic surgery.  When I woke up I had a patch over my stoma site, no dreaded JP hooked inside my pelvic area like I did with the big surgery, and No Catheter to pee for me. Just the morphine pump until I didn't need it anymore. The pain is nothing compared to the big surgery, so try not to worry about that because you got through the first one, and that's done.

If you're in pain, tell them and they will help you manage your pain. Keep in mind as long as you are on pain medicine your bowels will be very slow to wake up.  I was not allowed food or fluids (only ice chips) until I passed my first gas, and that was on day 2. After that I asked for an egg salad sandwich on plain bread and broth for the protein, carbs, and warm liquid. You will need protein in your first few weeks to regain strength. Try to have something warm to drink, that might be easier on your bowels waking up. My first BMs were liquid green bile, and that was just my intestines cleaning out bile and anything that was sitting in there over the past few weeks so don't be surprised if you see green sludge coming out. I was discharged on the 5th day when I was able to swallow solid food and no vomiting (at all, ever), just a tiny bit of nausea which was treated with a dose of anti nausea meds. Try your best to get out of bed and walk as much as humanely possible to get your new bowel to wake up. It's been sleeping for weeks while your stoma did the work, so try to gently help it along. The nurses will still come every few hours to check your temperature, take blood once a day, blood pressure, and possibly a blood thinner. 

Along with a book, sweater, slippers, socks, water bottle,  I took my travel bidet bottle with me to hospital. The first time I had a BM (even though it was just green bile) I needed the bidet to keep the area free of acidic leakage which causes raw painful skin. If you only use toilet paper (even the softest most expensive type), the area might not be as clean as bidet clean. Besides, the hot water from the bidet bottle was very soothing, and there's nothing like feeling clean to make you feel 100 times better. I used their toilet paper to pat dry. I didn't bring Calmoseptine, and actually didn't need it until my first bout of pouchitis which caused burning from extreme frequency. Now I use Zincofax, but rarely need it.

Try not to lift anything heavier than 10 pounds, just like after your big surgery. Let your stoma site heal. Get good sleep. Let your body heal without stress or anxiety. Bowels do not like stress or anxiety. They seize up. Try not to worry. If you need to worry, give yourself 30 minutes to worry each day, and then get on with your day. You might still have some back pain until your abdominals regain strength. You might feel some tension or itch around your healing stoma site while the small wound closes and finishes healing. I showered as soon as I got home and it didn't hurt the stoma site. It had already closed a lot while I was in hospital. I walked outdoors every single day and hopefully you will have mild spring weather for fresh air and walking exercise. That will help you regain strength. Six weeks after my takedown I was gardening lightly and slowly dragging bags of debris. It was spring. Good luck with your takedown. You'll be home before you know it.

CTB, I understand about the work issue and getting the surgery done. Luckily I'm  not even 24 yet and am in school. Although I took off this semester for my surgeries. I'm lucky I had the opportunity to get it done now and not later on in life when I end up with cancer because I had severe UC for over 11 years since I was 13. 

I am getting a pouchogram done in the morning with the enema and contrast to make sure my jpouch is not leaking before my surgery and I have ore admission testing next week since my take down is only 2 weeks away. I'm dreading this enema... is it painful ? My stoma already hurts so I know this is gonna be uncomfortable.. and  I'm a male. 

I don't recall that it was painful at all, just a little uncomfortable.  It didn't last very long and I was able to see the pictures after with the radiologist.  The bag filled up a little with fluid, but not bad at all.  It'll be over before you know it.  

Hey KC23,  Let us know how you made out today.  

It sucked. I wish I had taken my pain medicine before lol. But they are strict in here in GA about it that I just try to conserve it.. I thought it would be like a fleet enema , but nope. They taped the enema down and made me move in all these different angles. They weren't allowed to tell me if my jpouch was leaking or not but I knew that before they did the x-rays. Hopefully all is well. I could see my jpouch for the first time on the computer screen but idk if my surgeons office will call me to tell the results of if they will tell me next Wednesday when I'm supposed to see my surgeon and do my pre op surgery stuff since the following Tuesday I have takedown ! (If my pouch isn't leaking)

Sorry to hear that.  Yes, I do remember having to move around in different positions.  Did they insert a tube and then run fluid through your rectum and into the bag?  That's how mine was done.  I remember they had to get a thinner tubing because things were a little tight down there.  Anyway, good luck with upcoming appointments and takedown.  

The surgery itself is easy compared to the others.

What follows afterwards is different for every person. Many people have a rough time of it at the beginning and in the following months but personally speaking, I was out of hospital in three days, I don't remember any great pain, I had no urgency, no issues going to the loo and although there was some painful butt-burn for a month or so, I got by just using normal, wet toilet paper. A year later I have an excellent quality of life and the butt-burn has pretty much vanished. I cross my fingers that it will carry on like this.

So don't get too nervous, things might go easier than you expect and if you do have problems at the beginning like most people, it'll get better as the months go by.

Good luck!