Facing an ileostomy is a life changing event, but medical science is finding ways to improve the process. The old school method of dealing with waste for those who have their colon removed due to trauma or disease was cumbersome and could be disabling. With advanced treatment options like the Kock pouch, these patients are finding ways to live their lives without the constant worry that comes with an external bag system. How do you know if you are a candidate for a K-pouch, though?
The Kock, or “K,” pouch is a continent ileostomy, meaning the surgeon reconfigures the small intestine so waste is kept inside the body until released. This is different from the traditional external pouch method that utilizes a bag kept outside the body as a reservoir.
The Kock pouch allows the surgeon to fashion a reservoir out of the terminal ileum that collects bowel contents. A valve connects to the skin surface and the patient catheterizes it three times a day. The contents go directly into the toilet.
A K-pouch is both a personal and medical asset. Patients with external bags must deal with stool leakage and the smell of gas. The external appliance is messy and cumbersome. The Kock pouch design internalizes the reservoir so there is less possibility of leakage or smell.
There are fewer appliances to worry about, as well. Instead of emptying the bag out, the patient can go into the bathroom and use a catheter to drain the internal pouch.
There are known complications that come with external pouches. The leakage of stool can lead to skin irritations and infection. People with poor ileostomy function are at risk for hernias, painful fistulas and a prolapsed stoma that require surgical repair.
The Barnett Continent Intestinal Reservoir, or BCIR, is an advancement of the Kock pouch that improves the quality of the patient’s life. A BCIR modifies the pouch design to create a lateral reservoir with a single suture line. The BCIR procedure creates a more manageable waste removal system.
Ultimately, it is up to the surgeon to decide which ileostomy procedure is the right choice for you. Both the Kock pouch and a BCIR require the patient to have an adequate length of small intestine available to create the reservoir. This procedure is a good choice for those with a history of medical problems caused by an external pouch or anyone who wants to live bag free. The K-pouch and BCIR both put the patient back in control of their bowels, allowing them to live free of the burden of an external bag.