I had a j pouch for 30 years that had to be removed due to recurrent high grade dysplasia and a malignant polyp in the anal canal. I strongly did not want an ileostomy with its associated issues. Fortunately, I did research on the K pouch and BCIR, two options that do not require having an external bag. I opted for the BCIR, which has worked out very well for me.
Removal of my j pouch was more difficult than normal due to dense adhesions that resulted from three previous surgeries, but my surgeon was able to do everything (including the BCIR) in one operation. I had no problems making the 12 hour trip home by plane and car and was able to do many of the activities I enjoy soon after returning home. It took a while to fully adjust to my new plumbing, but I am able to do anything I enjoy (including heavy lifting) and eat a normal and healthy diet. I have no pain from the procedure, no leakage and empty my pouch 3-5 times a day at my convenience with a small plastic catheter. Although I had a significant weight loss after surgery, I regained over half of it back and now need to keep from gaining more. My bottom healed very quickly and I have no feeling down there that I have to “go”. I do feel internal pressure when my BCIR pouch is full, but that is just a signal that it is time to empty it. There is a lot of information about the K pouch and BCIR that I would recommend if your son would have interest in either of these procedures. Best of luck with whatever you decide to do.
Bill