I made 4 trips to Eastern Europe, skied in the Rockies and participated in equestrian competitions with a J pouch. Although I did have a few problem episodes, for the most part things went well. If a J pouch does not provide acceptable results, you can always get a K pouch or BCIR, procedures that do not require having an external bag. There is lots of information in the internet about these procedures and I suggest that you do your research before making a decision.