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Although I am a strong advocate for the BCIR (it has worked out very well for me), I would never go so far as to say, “don’t do the j-pouch”.  The majority of people with j-pouches have had acceptable to very good results with this procedure.  You will not see many of them posting on this forum.  Unfortunately, you are one of the ones who did not have acceptable results with your j-pouch and for which the BCIR was a very good option.  Anyone faced with the loss of their colon should research all  the options available to them, and perhaps get a second opinion and/or talk with people who have had these procedures, before making their decision.  By the way, Dr. Ernest Rehnke in Florida did my BCIR and I have the highest regard for him and the hospital staff.

Bill

Yeah, BCIR and other continent ileostomies are a good alternative, but they will not replace the j-pouch.

 

Remember, the Kock pouch predated the j-pouch and the j-pouch mostly replaced it because of its simplicity and overall good results. Still, there are many instances where a continent ileostomy is a good choice, particularly for those who have failed j-pouches or are not candidates.

 

I just wish that the continent ileostomy was available in more areas, not just for the primary surgey, but for follow up too. It can be a real pain if you have complications and have to travel large distances just to be evaluated!

 

Jan

I have had a k pouch for 35+yrs and have known a lot of complications linked to the valve and its fragility...although mine went pretty much touble free for 20yrs once it started having problems they persisted until I had to have a full valve revision (actually 5)...k pouches and BCIRs should be the last result, not the first choice.

If at all possible one should, at all costs, try to retain the natural exit and the simplicity that having a normal exit involves.

Do not forget that whether a k pouch or a BCIR you are dealing with diversions of the natural anatomy, requiring tubes, lube and a rather specific, low fiber (or for some fiber-free) diet with limited carbs.

You must have your tube, lube and preferably a large 60cc syringe or bulb syringe with you at all times and that is not negotiable.

I absolutely love my k pouch and have fought long and hard to keep it but if it had been a possibility I would have chosen  a j pouch first.

A healthy j pouch can be easily converted into a k pouch if required but the opposite is not possible. Once that bottom exit is closed it is closed for life.

You are also very, very limited if you have a problem. Living in a foreign country where k pouch surgeons are practically unheard of and the surgery is totally unknown to 99.9% of doctors, surgeons and ERs that I have come across, you don't want to have a problem far from home (and I am in France not an Eastern block country or a war-zone). 

I am thrilled that k pouches/BCIRs and their surgeons sitll exist but I strongly suggest to anyone asking to go for a j pouch unless otherwise medically indicated.

Sharon

 

 

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