An anastomosis from colon surgery can take several weeks to fully heal. Checking in with your care team is important, as problems such as anastomotic leakage need immediate attention.

If a section of your colon develops a disease or blockage, doctors may need to remove that section. They can then surgically connect the two remaining portions of your colon to allow your colon to function as usual. This connection is called an anastomosis.

Most intestinal surgeries result in an anastomosis. You may need to undergo intestinal surgery for conditions such as:

  • colorectal cancer
  • intestinal polyps
  • bowel gangrene
  • diverticulitis
  • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • bowel perforation
  • chronic constipation

If you’ve recently had intestinal surgery or if a healthcare professional has recommended it, you may be wondering what to expect during recovery. In this article, we’ll review the healing time of intestinal anastomosis and what symptoms to look out for that may signal complications.

An intestinal anastomosis takes at least several weeks to heal. Healing occurs in stages and is similar to skin wound healing.

During the procedure, your surgeon will either stitch or staple together two structures, such as loops of your intestine, to form a continuous connection.

Intestinal tissue heals in three overlapping phases.

Inflammatory phase

This initial healing phase takes 1–4 days immediately after the surgery.

In this phase, blood clots form, stopping the flow of blood. This is called hemostasis.

Blood platelets release messenger proteins called cytokines and growth factors. These help the small blood vessels near the anastomosis absorb the inflammatory white blood cells that your immune system releases during healing.

Your white blood cells protect you from germs that cause infections. They also produce growth factors that stimulate healing.

Proliferative

This phase usually starts around day 4 and lasts for about 2 weeks.

During this phase, cells called fibroblasts work to replace existing blood clots. Fibroblasts secrete collagen proteins into the area. This supports the formation and connection of healthy tissues.

As the number of fibroblasts increases, the number of inflammatory white blood cells decreases.

Smooth muscle cells also start to form, providing structure and strength to the area.

Remodeling

The remodeling phase involves healing that continues beyond the second week after surgery. This is the longest stage of healing. You can expect to be in the remodeling stage for an additional few weeks or longer.

During this stage, you should feel increasingly stronger and better able to function.

Fibroblasts will continue generating durable collagen and will remain the dominant cell type within the anastomosis. Over time, the area will become stronger and fully heal.

Several factors determine your recovery time, including:

  • the reason for your surgery
  • your overall health
  • your age
  • the occurrence of complications such as infections or anastomotic leakage

You may be more prone to surgery complications that can slow down healing if you have risk factors such as:

A potentially dangerous complication of this procedure is an anastomotic leak, in which the contents of your colon — such as food particles, enzymes, and bacteria — leak through the anastomosis. This can happen if the surgically connected intestinal loops don’t seal or heal completely.

An anastomotic leak can lead to a serious infection if it is not treated. Contact your doctor if you have symptoms such as:

  • nausea and vomiting
  • fever
  • stomach pain
  • pain in your left shoulder
  • racing heartbeat
  • low blood pressure
  • wound drainage

The inability to pass stool (postoperative ileus) is another possible complication that requires a doctor’s care. Symptoms include:

  • inability to pass gas
  • constipation
  • swollen abdomen
  • stomach cramps
  • nausea
  • vomiting of stomach contents that appear stool-like

What is the success rate of bowel anastomosis?

This procedure is typically successful in people who don’t have risk factors for complications. Even if complications happen, treatments are available to manage or resolve them, improving the outcome of the initial surgery.

What are the long-term complications of bowel anastomosis?

Long-term complications are typically due to anastomotic leaks (discussed above) or anastomotic stricture (aka anastomotic stenosis).

Scar tissue that forms at the surgery site causes anastomotic stricture. The scarring narrows the passageway formed by the anastomosis, slowing or blocking the passage of food through the digestive tract.

Like anastomotic leakage, stricture is treatable.

Can you have an anastomotic leak years later?

Yes. While less common than earlier leaks, anastomotic leaks can occur months or years after surgery.

An intestinal anastomosis is a connection a surgeon forms between two parts of your colon to support typical digestion and elimination.

The initial healing phases last about 2 weeks, but it will be several more weeks before you can return to regular functioning. During this time, it’s important to look out for complications such as anastomotic leakage, which can slow down healing and cause long-term problems.