Here's my story and current predicament:
I’ve had IBD for 23 years and finally scheduled surgery for next week. The interesting part of my story is my first doctor classified me as Crohn’s and my second doctor has me now classified as UC. There are obviously much different surgical results based on what I truly have. I've never had inflammation in the small bowel and it seems to follow the standard UC pattern of more severe inflammation starting in the rectum and diminishing as it goes along. But I do seem to have some more typical Crohn's manifestations mainly not so much rectal bleeding and clubbing of the fingers. Along with more typical UC findings of pseudopolyps, and never any fistulas, fissures, strictures or abscesses, cobble-stoning.
I have an experienced surgeon who knew about my previous Crohn's diagnosis and he was all set for the two stage surgery where he builds the pouch in stage 1 and it wasn't until I brought up how I had some doubt about it truly being UC where he said we could go the three stage route and use the pathology of the colon after stage 1 to determine the next step. What's interesting is he said if we did the two stage and the pathology showed Crohn's he would still connect the jpouch since it had already been made. I know some specialized centers allow special cases of Crohn's disease (no small bowel or perianal disease) to try for a jpouch and I think I would have sought them out anyway if I was told I wasn't a jpouch candidate by my current hospital.
But anyway he left the ultimate decision up to me and gave me up to the day of the surgery to decide which route to take. I would love to avoid three surgeries and since I had the idea of trying the pouch even if it was Crohn's, I think I might have a unique opportunity here if I go with two surgeries. On the other hand I heard having a pouch when it is actually a Crohn's diagnosis can be hell.
Sorry for the length of this but I was just wondering if anyone else was faced with a similar predicament and what they chose to do.