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I have a friend who had an ileostomy over fifteen years ago.  She has a lot of trouble with leakage and is sick of having to deal with the ileostomy.  Her rectum was removed during the surgery (Barbie Butt).  I had J-Pouch Surgery 2 years ago and we talked about how well I've done so she talked to a doctor about getting a reversal whiwaste were sure he would say no because of Barbie Butt.  Would she be a candidate for the K-Pouch?  If so why wouldn't he have mentioned this to her?  I may not fully understand the K-Pouch so please forgive me if I'm way off base here

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There are two continent ileostomy procedures: the k pouch and the similar BCIR.  A large percentage of these procedures are performed for people who have significant problems with their ileostomies and desire a better quality of life.  Lots of information is available online for both of them.  An excellent website on the BCIR is: www.bcir.com and it has a video presentation about the procedure and information about the benefits and risks.  Unfortunately, there are only 2 surgeons who do BCIR’s in the USA plus a limited number who do k pouches.  Both procedures involve creation of an internal pouch with a valve created from small intestine tissue that holds all stool and gas inside until it is emptied (typically 3-5 times a day at your convenience) with a small plastic catheter.  The button-hole stoma is flush with the skin, located below the belt line and is covered with a small piece of gauze (no bag needed). You can do virtually all the activities you enjoy and no one knows you have it unless you tell them.  I am enjoying a high quality of life with a BCIR and am thankful I selected it instead of a conventional ileostomy.

 

Since your friend already has an ileostomy, it will be necessary to provide medical support to the insurance company for converting to this procedure. Without medical support, they may deny coverage by claiming that it is elective and cosmetic in nature.

Ceew,

I agree with everything that Bill has to say.

I have a k pouch and know for a fact that few surgeons and even few doctors know what a K pouch (or BCIR for that matter) are.

In the 70's the k pouch was touted as the 'new' thing in colorectale surgery...but was rapidly replaced by the j pouch in the 80's because it uses the natural exit and requires so much less upkeep.

Those with a healthy sphincter were winners but those with pre-existing ileostomies or who had sphincter problems were out of luck.

That is the only reason they kept doing them to a very minor degree and new k pouch surgeons were rarely trained.

The 1st thing that she has to do is find a site like the Cleaveland Clinic or the Mayo and look at the surgery and who does it in her region (there is a master list on this site)...then talk to a competent surgeon who does them.

If she has never had crohns and is a good candidate then there is no reason that she couldn't have one done...but she just needs to know that the vavle is very tricky and should be done by an experienced k pouch or BCIR surgeon...you can not improvise this.

If she has any questions she can post here and we will answer.

Wish her luck from us

Sharon

 

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