Colostomy reversal w chronic use of prednisone, temp ileostomy planned

Posted by cgrogers @cgrogers, Aug 28, 2023

I had an emergency Hartman procedure (sigmoid Colin removal) for a perforated bowel due to diverticulitis last November 2022 and have discussed reversal with the colorectal surgeon. Have been taking 10mg prednisone daily for years for a neurological autoimmune disease and this increases the risk of the reconnection not healing. This was the reason the bowel was not reconnected at the time of the emergency surgery. He suggested a temporary ileostomy to give the reattached bowel time to heal and a plan to then reverse that 3 months later.

I’d appreciate your thoughts and insights from anyone who has been through this and taking prednisone, thinking those with IBS etc may be in that situation, how was that dealt with, and anyone whose gone from a colostomy to a temp ileostomy as suggested.
Thanks !

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mary6787 | @mary6787 | Aug 29, 2023

I’m going through a very similar situation. I had an emergency Hartman surgery in January, removing 18 inches of perforated descending colon. Ischemic colitis is what the medical team guesses was the cause, but my case is still somewhat of a mystery. After five months with my colostomy, I had reversal surgery on 6/19, but the anastomosis leaked twice under testing. My surgeon was able to get it sealed the second time, but wisely decided to leave it place to heal for three months. So I have a temporary ileostomy now. In regards to your use of prednisone, I was put on an intense course of it after a CT scan on Christmas Eve revealed the colitis that was causing my severe pain and IBS-constipation symptoms. It was just 3 weeks later that my colon perforated, leading to the emergency surgery.
I’m fortunate enough to have an appointment in late September at Mayo Rochester with a G.I. to investigate my case further. I never really thought about the prednisone being a factor, but I also have a genetic autoimmune factor that might be part of the equation. I hope you get some answers as well!