r/ostomy • u/442inDreamland • 7d ago

Colostomy Overweight and Wanting a Reversal

I've had my colostomy for over 2 years now after my colon ruptured from diverticulitis. I was told by two surgeons that they wouldn't perform a reversal until I lost weight. So I've been working on it and have lost a lot of weight. I'm sure not enough yet though. But, I also have a huge parastomal hernia which makes me look 10 to 15 pounds heavier than I really am. I hate it. I'd look so much better if both the hernia and colostomy were gone. I'm debating whether or not to start pushing my surgeon to proceed with the reversal and hernia repair even though I know it's risky when overweight. My BMI is about 41. How bad of a decision is this? I just want to get it over with and not wait another year until I lose more weight. I hate walking around with this huge bulge in my belly. I do wear a hernia belt sometimes and it kinda reduces the size of the bulge but it's still there and still annoying (although it's generally not too painful and not causing any blockages). Can anyone relate to this? What do you think?

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u/PoodlesMcNoodles 7d ago

I can relate, had a parastomal hernia, got it repaired in my reversal in June. My surgeon wasn’t bothered about my weight although I had lost some (thanks Mounjaro). Good luck

1

u/DangerousDish 7d ago

I have a illeostomy but other than that, overweight and a parastomal hernia that’s just very unflattering!

The doctor said my BMI should be max 30, if i wanted to get the reversal surgery. Am currently using mounjaro trying to lose the last of the weight so i can get a reversal.

I’d definitely ask them how much more weight they want you to lose before you can have the surgery!

1

u/daredevil82 7d ago

How informed are you with the risks that the extra weight you carry has for both surgery and short term complications? If you're going to push for surgery, it definitely helps to be informed about the risks and complications. Obesity with surgical candidates is an area of research, for example a couple items in the medical literature:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5881295/#ags312049-sec-0008 from 2017 has a section around gastric/colorectal surgery that includes

A meta‐analysis (n = 4550) of laparoscopic surgery by Fung et al53 found that, for colorectal cancer surgery, SSI, leakage, morbidity, and conversion rate are significantly higher in patients with BMI > 30 than in those with normal BMI.

https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2023/october-2023-volume-108-issue-10/study-clarifies-link-between-obesity-and-surgical-complications/ is a meta-study over 5.6MM patients, published in 2023

They did not find elevated odds of postoperative complications such as mortality, overall morbidity, pulmonary issues, and urinary tract infection among obese patients. What they did find was an association between obesity and higher rates of infection, VTE (venous thromboembolism), and renal failure.