Concierge colorectal · UK
Loop ileostomy reversal, by a consultant colorectal surgeon.
Closure of a defunctioning loop ileostomy — 8 to 16 weeks after your primary operation, once a pouchogram confirms the anastomosis has healed. Continuity of care with the surgeon who did the first operation, where possible.
Why patients choose us
- 01
A colorectal surgeon who did the first operation — or works with one who did
Reversal is safer when the surgeon knows the anastomosis. We keep continuity of care where possible.
- 02
Pouchogram read before you commit
We do not book a reversal until the distal anastomosis has been imaged and cleared. No leak, no stricture, no surprises.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a loop ileostomy reversal costs in the UK.
Fully funded on the NHS. Indicative private ranges across our partner clinics — we quote firm figures within one working day.
In short
Private reversal, all-in: £6,000–£11,000, home in 1–3 nights. NHS pathway fully funded.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Loop ileostomy reversal (private, all-in) | £6,000–£11,000 | 60–90 min theatre | 1–3 nights |
| Consultant colorectal surgeon consultation | £250–£450 | 30–45 min | Same visit |
| Defecating pouchogram / rectal contrast enema | £450–£850 | 20–30 min | Same day |
| Flexible sigmoidoscopy (if needed) | £850–£1,500 | 20–30 min | Same visit |
| MRI pelvis (if stricture concern) | £450–£950 | 30–45 min | 24–48 h |
| NHS pathway | Fully funded | As above | Waiting list |
Prices vary by hospital, by which surgeon does the case, by the anaesthetic chosen, and by whether prophylactic mesh is added. Length of stay changes the final bill more than any other factor.
The problem
The right surgeon, at the right time, with the right imaging first.
Reversal is not a small operation. Book it too early and the anastomosis leaks; book it with the wrong team and you lose continuity with the surgeon who knows your case. We fix both.
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Pouchogram first, always
No reversal without imaging that confirms the distal anastomosis has healed — no leak, no stricture.
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Continuity of care
Where possible, the surgeon who did the first operation does the reversal. They know your anatomy.
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ERAS pathway from day one
Enhanced Recovery — early feeding, early mobilisation, discharge in one to three days for uncomplicated cases.
The journey
From enquiry to recovery — what happens, in order.
One team from first message to bowel rehab — including the LARS conversation if it comes up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Theatre and recovery
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. When your primary operation was, why the ileostomy was formed, how you have been getting on with it.
- 02
Before
We come back with a recommendation
Within one working day: whether the timing is right, whether a pouchogram has been done, and which colorectal surgeon to see.
- 03
Before
Pouchogram and pre-op work-up
A defecating pouchogram or rectal contrast enema confirms the anastomosis has healed. Bloods, ECG, anaesthetic review.
- 04
On the day
Admission and theatre
Admission on the day. Regional or general anaesthetic. 60–90 minutes in theatre. The stoma is dissected out, bowel joined, wound closed.
- 05
On the day
Recovery bay to ward
ERAS pathway — oral fluids the same day, mobilise the same evening, catheter usually out overnight.
- 06
After
Home in one to three days
Discharge once eating, drinking, passing wind or stool, and comfortable on oral pain relief.
- 07
After
Bowel rehab and review
Bowel function settles over one to four weeks. Office work at two to four weeks. Pelvic floor physio if LARS symptoms develop.
Typical timing: 8–16 weeks after primary surgery. Bowel rehab: 1–4 weeks.
When it helps
When loop ileostomy reversal is the right step.
The situations we see most, plus the one red flag on imaging that means the reversal is delayed rather than booked.
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Defunctioning stoma after low anterior resection
A loop ileostomy formed to protect a colorectal anastomosis after rectal cancer surgery — reversed once healed on imaging.
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Ileal pouch (IPAA) protection
A loop ileostomy protecting a newly formed ileal pouch after ulcerative colitis surgery — reversed once the pouch has healed.
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Redo anastomosis or complex bowel surgery
A defunctioning stoma protecting a re-do or high-risk anastomosis — closed once distal imaging is clear.
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IBD-related quick recovery
Some patients with inflammatory bowel disease heal quickly and are candidates for earlier closure.
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After adjuvant chemotherapy
If chemotherapy was needed after your primary operation, reversal usually waits until treatment is finished and you have recovered.
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Early closure (selected cases)
Some centres offer closure at 14–30 days per the PEACOCK protocol — for fit patients with a clean anastomosis. Evidence emerging.
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You are fit for another operation
Reversal is a real operation. We check heart, lungs, weight and general fitness before agreeing a date.
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Red flag: leak or stricture on imaging
If the pouchogram shows a leak or a tight stricture, reversal is delayed and the anastomosis is treated first.
Surgical technique
What happens in theatre — the parts that matter.
The technical choices your surgeon will discuss with you before the operation.
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Circular peristomal incision
A small round cut around the stoma — the loop of bowel is freed from the abdominal wall by careful dissection.
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Stapled side-to-side anastomosis
The two ends of bowel are rejoined with a linear stapler — quick, reliable, and now the most common method in the UK.
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Functional end-to-end anastomosis
An alternative stapled configuration used by some surgeons — same principle, similar outcomes.
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Hand-sewn oversewn anastomosis
The scarred loop is resected and the bowel oversewn by hand — used when the tissue is inflamed or scarred.
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Layered fascial closure
The defect in the abdominal wall is closed in layers to reduce the risk of an incisional hernia at the old stoma site.
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Prophylactic mesh (selected cases)
A mesh reinforcement of the fascial closure — increasingly used per the PROPHER trial for patients at high hernia risk.
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Purse-string skin closure
The circular skin defect is closed with a purse-string suture rather than a straight line — evidence it reduces wound infection.
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ERAS day-case or short-stay pathway
Enhanced Recovery After Surgery — early feeding, early mobilisation, discharge in one to three days for uncomplicated cases.
Our vetted UK network
A small panel of colorectal surgeons, we picked them.
Consultant colorectal surgeons across London, the Home Counties and major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant colorectal surgeons, not general surgeons or trainees
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Continuity of care with the surgeon who did your primary operation, where possible
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Access to same-day pouchogram, flexible sigmoidoscopy and MRI
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ERAS pathway with early feeding, early mobilisation and short stay
Safety and recovery
The complications worth knowing — honestly.
Reversal is a common, safe operation with a real complication rate. Outcomes are excellent — over 90% do well long-term — but the honest numbers help you plan.
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Anastomotic leak — 3–8%
The join between the two ends of bowel can leak in a small percentage of cases. Usually treated with antibiotics and drainage; occasionally needs a further operation.
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Ileus or obstruction — 5–10%
The bowel can be slow to wake up after surgery. Almost always settles with drip, decompression and time. Rarely needs re-operation.
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Wound infection — 5–15%
The stoma site is contaminated so wound infection is more common than at a clean site. Purse-string skin closure reduces the rate.
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Incisional hernia at old stoma site
Around 15–30% at five years — higher than a midline wound. Prophylactic mesh at closure (PROPHER trial) is emerging as a way to reduce it.
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Intra-abdominal abscess
A deeper collection can develop, usually near the anastomosis. Picked up on CT and drained by the radiologist in most cases.
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Enterocutaneous fistula (rare)
An abnormal channel from bowel to skin — uncommon but sometimes seen if a leak fails to seal. May need further surgery.
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Medical complications
Chest infection, DVT, cardiac events — the usual risks of abdominal surgery, higher in older patients and those with co-morbidities.
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LARS after low anastomosis
Lower Anterior Resection Syndrome — frequency, urgency, clustering and incontinence — is common after low colorectal joins. Bowel rehab, pelvic floor physio and biofeedback help; severe cases may need sacral neuromodulation.
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Rare need for re-diversion
If the anastomosis fails badly, a Hartmann’s procedure or permanent end colostomy may be needed. Uncommon, but honest to mention.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and pre-op imaging
Why the reversal was done — the primary operation, the pouchogram findings, and confirmation that the anastomosis had healed.
- 02 Technique
Anaesthetic and surgical technique
Regional or general anaesthetic, the incision used, how the loop was mobilised, and the type of anastomosis — stapled side-to-side, functional end-to-end, or hand-sewn.
- 03 Findings
Anastomosis, adhesions and fascial closure
Notes on the quality of the bowel, any adhesions from the first operation, and how the fascial defect was closed — with or without prophylactic mesh.
- 04 Impression
Recovery, bowel rehab and review timing
Read this first: expected recovery, when normal bowel function usually returns, LARS risk, and when to be seen again.
Recognised by major UK insurers
Cover for ileostomy reversal is usually funded when medically indicated after cancer or IBD surgery. We confirm cover before booking.
Frequently asked
Everything we get asked about loop ileostomy reversal.
Quick answers on timing, imaging, LARS, and what recovery actually feels like.
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When is the right time to have my loop ileostomy reversed?
Usually 8 to 16 weeks after the primary operation, once the anastomosis has healed on a pouchogram. If you needed chemotherapy afterwards, reversal is delayed until treatment is finished and you have recovered. Some centres offer early closure at 14–30 days per the PEACOCK protocol for selected fit patients.
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What imaging is done before the reversal?
A defecating pouchogram or rectal contrast enema is the standard test — it confirms the distal anastomosis has healed with no leak and no stricture. Flexible sigmoidoscopy or MRI is added if there is any concern.
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How long does the operation take, and how long will I be in hospital?
The operation takes 60 to 90 minutes. Most uncomplicated reversals are a one- to three-night stay on an ERAS pathway. A small number of very fit patients are done as day cases.
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How much does a private loop ileostomy reversal cost in the UK?
Roughly £6,000 to £11,000 all-in — surgeon, anaesthetist, theatre and one to three nights. On the NHS it is fully funded. Pouchogram is £450–£850 and consultation £250–£450 if arranged privately.
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How long until my bowels work normally again?
Bowel function usually returns over one to four weeks. Expect frequent, loose motions at first — the bowel needs time to adapt to being back in circuit. Most people are on top of it within a month.
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What is LARS and will I get it?
Lower Anterior Resection Syndrome — frequency, urgency, clustering, occasional incontinence — is common after a low colorectal anastomosis. Many patients improve over a year with bowel rehab, pelvic floor physio and biofeedback. Severe cases can be treated with sacral neuromodulation.
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What is prophylactic mesh at closure, and should I have it?
The stoma site has a high rate of incisional hernia — 15–30% at five years. A mesh reinforcement of the fascial closure (studied in the PROPHER trial) appears to reduce this. It is not standard everywhere yet; we discuss it with your surgeon on a case-by-case basis.
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When should I contact the surgeon or A&E urgently after reversal?
A fever, worsening abdominal pain, distension, vomiting, spreading redness around the wound or heavy bleeding are all reasons to seek same-day medical help — an anastomotic leak or obstruction needs picking up early.
Related treatments
Looking for something else?
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Ileostomy formation
The operation to form a defunctioning or end ileostomy.
Learn more -
Ileo-anal pouch formation
Pouch surgery after colectomy for ulcerative colitis.
Learn more -
Colostomy reversal
Reversal of a defunctioning or Hartmann’s colostomy.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more