Dr. Don Schiller - The Ileostomy Specialist
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Dr. Don Schiller has retired from his practice
involving BCIR and Kock Pouch surgery.

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Diagnosed with UC? Here are Your Ileostomy Alternatives

December 27, 2017  ·  By: Dr. Don Schiller

If you’ve recently been diagnosed with ulcerative colitis, you’ve probably discovered there’s no cure for the inflammatory bowel disease. Rather, as the condition progresses, you’ll have to find ways to manage the symptoms so you can stay in good health. 

For many patients, a colectomy, or removal of the colon (large intestine), is the best way to manage the disease. The colon serves to process and expel waste from the body, so when it’s removed, you’ll need a way to maintain fecal continence.

An ileostomy is the solution. Essentially, an ileostomy creates an opening somewhere on the body where waste can be manually removed. Thanks to advances in modern medicine, there are several ileostomy alternatives.

The Conventional Ileostomy

During this procedure, the entire colon is removed and a stoma (or opening) is created on the patient’s abdomen. An external bag is worn over the stoma to collect waste. It must be emptied several times during the day to avoid mess and odor. 

The J Pouch

No external device is required with a J Pouch. A surgeon connects the end of the small intestine with the anus so the patient can continue to have bowel movements. However, many patients experience as many as seven bowel movements during the day and night, and they don’t always have control over when a bowel movement will occur.

The Kock Pouch 

For many years, the Kock Pouch was the gold standard for people who have had their colons removed. During the procedure, the surgeon makes a reservoir using the patient’s small intestine. One end of the reservoir is connected to the small intestine; the other end connects to a stoma, or opening on the skin. The reservoir is usually located just above the pubic bone. 

Waste accumulates in the reservoir and a catheter must be inserted several times a day to empty waste from the body.  The number of times the reservoir needs to be emptied will vary from patient to patient and may change as the ileostomy "matures."

The Kock Pouch works remarkably well, but there are some drawbacks. Patients are at increased risk of developing a fistula, which causes leaks, pain, swelling and other complications. A Kock Pouch can also leak if the reservoir becomes too full. 

The BCIR

The Barnett Continent Intestinal Reservoir (BCIR) is a modification of the Kock Pouch that prevents leaks and lowers the risk of fistulas. The design of the reservoir and stoma prevent fluid and gas from leaking, even when full, and since the procedure requires fewer sutures, fistulas are less likely to develop. 

Ulcerative colitis patients looking for frustration-free ileostomy alternatives should consider the BCIR first. This modern approach to the ileostomy ensures a good quality of life. Dr. Schiller has perfected the BCIR ileostomy and is available to talk further about its benefits. Call today to schedule a consultation.

Retirement Announcement

Dr. Don Schiller has retired from his practice involving BCIR and Kock Pouch surgery. To find a surgeon who can help you, go to www.qla-ostomy.org and click on the tab Medical Info and you will see a Directory of all the surgeons in the country who perform Continent Ileostomy surgery.

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