Are there 2 types of J pouches? One is a pouch made up of the small intestines which is the same pouch used in BCIR. The other one is made up of colon stacked together to form a "new rectum". Is this true?? I have been reading a lot about internal pouches since I can't have a reversal of my ileostomy due to stricture colon. I had a low anterior resection to cure my stage 1 rectal cancer in Feb of 2015.
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All j-pouches are created to replace the rectum, thus are considered a "neo-rectum."
Most members here have an ileal j-pouch, made from the small intestine and have had a complete removal of the colon and rectum for ulcerative colitis or polyposis.
In the case of rectal cancer with a low anterior resection, a colonic j-pouch may be created to replace the rectum.
The difference between the two is that a colonic j-pouch will produce a function more similar to a normal colon and rectum, while an ileal j-pouch will have normal function of more loose stool and higher frequency, because of the lack of a colon to absorb water.
They do not make a BCIR or other continent ileostomies unless you have no colon left. Those are always ileal pouches.
Hope this helps.
Thanks for the quick clarification.
So, if I was to get either a ileal j-pouch or BCIR, can't they just have the rest of my colon removed? I just don't want to have a ileostomy bag or a colostomy bag for the rest of my life.
Yes, if you have too much stricturing in your colon, they can remove it. I am not sure how much colon is needed to do a colonic j-pouch, so that may still be an option.
That, none of the options are guaranteed, as it all depends on your individual anatomy and if there are internal issues, like adhesions, that may interfere with other surgery. BCIR is not done in very many centers. The Kock pouch is more common, but even that is not done in many hospitals. If you go to the K-pouch Forum, there is a list of surgeons that do it.