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Reply to "j-pouch vs Ostomy"

Hi, Cindy.  Note that when members mention emptying their pouch they are talking about their internal J pouch, not the external ostomy bag that would sit on your stomach to collect stool (also called ‘an appliance’).

Emptying a (J) pouch is simply finding toilet, sitting down, and pushing gently to expel stool, just as people with a normal colon do. The amount of time needed on the toilet depends on if you have semi solid stools, watery stools, or solid stools. Watery would come out fast, solid can be just as quick, unless you have very hard solid stools as if constipated. This might take a few minutes. This happens to me sometimes because I have solid formed stools more than half of the time. If you do get a J pouch, you’ll know the urge to use the toilet by the slight pressure, or a sense of urgency. It’ll be different to the extreme urgency that comes with ulcerative colitis. When a J poucher gets used to their new plumbing system there is time to find a bathroom without the feeling of emergency. For the first weeks, months after J pouch surgery there is frequency but you will learn quickly how to manage it by food choices, time of day you eat your meals, hydration, and where public bathrooms are located. Try not to worry about this because there are public bathrooms everywhere.

When I had my temporary ostomy for 12 weeks it would take a few minutes to sit on the toilet, aim the ostomy bag into the bowl and squeeze out the contents, maybe 1 minute, then wipe clean the opening and close the bag, 2 minutes. Five minutes tops?  Once I was in a public bathroom and some fool banged on the door making me very anxious. I would never bang on the door, knowing that the person might be in a situation like an ostomy or colostomy change!  At home,  I learned to do a complete change of the entire appliance and wiping the stoma area clean in 5 minutes flat, and I was out the door, always carrying a fresh change in a zip lock in my tote bag for emergency. A complete change might not be easy / possible in a public bathroom. Simply emptying, yes. The first time I had to do a complete change on my own, without the help of a community home nurse, I wept because it was so alien and it took me 30 minutes. You learn, and you manage. Lay out all your equipment on the bed or bathroom counter on a clean towel so it’s all at hand. Then everything goes very quickly. I kept all my ostomy supplies in a basket for easy access, and I could carry it all from bathroom or bedroom. My ostomy bag would sometimes leak while I was sleeping because I was lying down and stool pools around the stoma instead of falling into the bag. Standing or sitting would always be safer because stool would simply fall into the bag. I learned to sleep with lots of pillows boosting me up, almost in a semi sitting position. Not a great position for deep sleep but I managed and it was better than leaking and having to shower at 2am, but when I had to shower at 2am, I did it. And changed the thick towels I slept on for safety.

If you get a permanent ostomy, keep in mind the expense that goes with it unless you have excellent health insurance that covers all appliances, wafers, rings, pastes, barrier creams, etc. and these will be required for your entire life. With a J pouch, there is also expense if you have issues such as pouchitis and need creams, lotions, probiotics, or prescription antibiotic meds that hopefully are all covered by your insurance, maybe for life, hopefully not. I personally don’t have any expenses related to my J pouch, no meds, or creams, or pro/pre biotics, no special foods, and for this I am grateful. Shortly after I got my J pouch I installed a portable bidet (AmazonPrime!) on my toilet that Saved My Life and My Bum. If you decide on a J pouch, a portable bidet — or even a simple bidet travel bottle — add to the top of your list.

Let us know what you decide. You are doing the best thing in gathering intelligence to make your informed decision.

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