The IRA Procedure

it is my impression that with an ira procedure comes te risk of cancer of original retained rectum and this procedure is good for those at low risk of cancer and or minimal in involvement in terms of diseased bowel.

for example as someone  with fap, i would not last with an ira and its not widley done or offered. like i said your disease process has to be minimal, effect your bowel minimally. most of us as a majority have the ipaa surgery complete removal of diseased tissue/mucosa

i dont think theres anyone with uc on this board with an ira prcedure, and certainly not with fap. for what its worth.

best to you,

len

@Stoma BB posted:

Hi All

Has anyone had the IRA Procedure? If so how was the operation, recovery, how has it been and are you glad you had it?

Are you thinking about getting that procedure???

Hi Lauren yeah I’m keeping my options open to be honest until I see my surgeon

That is good! I have a J-pouch, do you think you might want to get a j-pouch instead of the IRA? When do you see your surgeon???

I’ve heard so many bad stories about the j pouch, it has really put me off, also the thought of having 2 more operations to get the j pouch is another big factor and having to have another stoma for 12 weeks to let it heal before the take down doesn’t appeal to me. The ira still has its problems like everything but from what I’ve researched there not as common, frequent or as problematic, only one surgery is also very tempting, i maybe completely wrong here but this is how I’ve seen the research

im meant to be seeing him today

@Stoma BB posted:

I’ve heard so many bad stories about the j pouch, it has really put me off, also the thought of having 2 more operations to get the j pouch is another big factor and having to have another stoma for 12 weeks to let it heal before the take down doesn’t appeal to me. The ira still has its problems like everything but from what I’ve researched there not as common, frequent or as problematic, only one surgery is also very tempting, i maybe completely wrong here but this is how I’ve seen the research

im meant to be seeing him today

Yeah I totally get where you are coming from, I completely understand, in addition to everything you said- its also so much more healing time and time to get use to things. I have had my J-pouch for almost 10 years and have been fine with minor complications as in not drinking much water and overeating at first without water, other than that, life has been perfect. And i go to the bathroom 14x or more per day.

You are right about the IRA for sure, you can still have anal sex if you choose to and you have more hold time if you need it. I understand your decision and there is not risk of pouchitis either, and way less scar tissue too! I am just afraid you might get Ulcerative colitis in the rectum and may still need medication, I am afraid that might happen but everything has cons. If I could do it all over again, I would still choose J-pouch just to be free from disease. But I understand everything you said if you want to avoid the long healing process of a J-pouch, healing processes are not fun lol.

How did your appointment go???

My situation in my opinion is very strange, I got diagnosed with uc when I was 19-20 got put on prednisone but came off them and tried to keep it under control through food and exercise, I’m a competitive bodybuilder you see, I was able to do this for 15 years and after my last competition last year it all flared up and they couldn’t get it back under control so I was sort of pushed into a operation quite quick, so they know I had uc but don’t know where it started from etc, so I do understand the worry of getting uc in the rectum but because I don’t feel I had uc that bad up until last year was hoping(wishful thinking maybe)that might not occur, but even if it does or if it fails if I’m correct in what I’ve read I can then go down the j pouch route?

Oh cool! I bet that is pretty fun! Physical or emotional stress can cause flares or flares to worsen so I think that is why you flared up the way you did unfortunately. I should also warn you, once you get a J-pouch it is not advised that you still do body building- were not suppose to lift anything over 20 pounds but some people on here do it anyway regardless of being warned by their doctors or people on this site. I cannot force you to quit body building after the surgery but it is not recommended. Regarding the IRA procedure, I am not for sure on the rules regarding that but I would not chance that if I had the IRA either.

Yeah you can always choose the J-pouch route if the IRA fails, I believe anyway, I do not see why you could not do that if you needed too. I would write that question down ask the surgeon today to get clear answers.

Are you saying you were told never to lift over 20 pounds? Or just for so many weeks after surgery? I don't do competitive wight lifting or anything like that but I've had my pouch over 30 years and never considered  that as a factor in deciding. whether I should attempt to lift something.

@Deb C posted:

Are you saying you were told never to lift over 20 pounds? Or just for so many weeks after surgery? I don't do competitive wight lifting or anything like that but I've had my pouch over 30 years and never considered  that as a factor in deciding. whether I should attempt to lift something.

There are a number of threads on this board about long-term lifting considerations, and it might be better to review those before restarting the same contentious conversation, especially in a thread about the IRA procedure. Here’s a link into the middle of one, and you can use the search feature to find others: https://www.j-pouch.org/topic/...1#654628431013198531

TL, DR: There have been anecdotal reports of severe pouch complications from lifting (amount of weight is murky), and some have reported being told never to lift even moderately heavy things. Context is sparse (e..g. were their pouches “at risk?”), and there’s no evidence that the lifelong voluntary disability being advised is proportional to the actual risk.

@Deb C posted:

Are you saying you were told never to lift over 20 pounds? Or just for so many weeks after surgery? I don't do competitive wight lifting or anything like that but I've had my pouch over 30 years and never considered  that as a factor in deciding. whether I should attempt to lift something.

Yes I was told that we are not ever allowed to lift more than 20 or 25 pounds. However there are a lot of people on here that do know this and do it anyway and there are people on here that need hardcore evidence to make changes. I think it is hard to find hard-core evidence about jpouches because j pouch surgery is not that old, its under 50 years old. That is why I rely on anecdotal stories because I want to have my j pouch be happy and live a good life with it since we start running out of options after we get our guts removed. I do not follow the 20 or 25 pound rule all the time, i get water softener salt for my water softener and the bag is around 40 pounds- I pick up the bag and put it into my cart and i pick up the bag to put in the water softener container. I would not recommend not following the 20 or 25 pound rule, I would strongly recommend to follow that rule since it came from a doctor.

Stoma BB How did your appointment go???

@Stoma BB, you can find stories of people having poor outcomes from any medical intervention. You can also find stories of good outcomes, and okay outcomes.

The way to make an informed decision is to look at the sudies showing outcomes from hundreds or thousands of patients, preferably over a long time span. We do have some of these studies now.

And then look at the stats in comparison to your own medical situation, if possible.

Then consider your lifestyle, personal preferences and access to medical care.

Have they tried biologics?