For people with certain chronic diseases of the colon, such as familial polyposis or ulcerative colitis, removal of the colon is often the best treatment. However, once the colon is removed, the patient must still be able to eliminate waste from his or her body. To allow the removal of waste, surgeons create an ostomy, which is a passage through which waste products can flow.
Traditionally, most patients received a conventional ileostomy. With this type of ostomy, the entire colon and rectum are removed, and the patient’s waste flows through a hole in the abdomen. Because waste flows continuously, the patient is forced to wear an external collection bag, which must be emptied at regular intervals throughout the day. Fortunately, conventional ileostomy alternatives are now available.
The ileo-anal J-pouch involves the removal of the colon and part of the rectum. However, the lower portion of the rectum and the anal sphincter are left behind. The surgeon then uses a portion of the patient’s intestine to create an internal pouch, which is connected to the anal canal. The patient can eliminate waste normally without the use of any external appliances or bags. However, this type of ostomy isn’t appropriate for all patients, and it is prone to failure.
With a continent ileostomy, the patient’s colon and rectum are entirely removed. Part of the patient’s intestine is constructed into an internal pouch with a valve that connects to a hole in the patient’s abdomen. This valve remains sealed until the patient is ready to release waste. To eliminate waste, the patient simply inserts a catheter into the valve. With this type of ileostomy, the patient can control when waste is released, and there is no need for any external appliance.
Two primary types of continent ileostomies are available: the Koch Pouch and the Barnett Continent Intestinal Reservoir (BCIR). The Barnett Continent Intestinal Reservoir is a revision of the Koch Pouch that addresses several of its weaknesses, thus improving patient outcomes. Because of its many benefits, BCIR is a popular alternative to the conventional ileostomy.
If you are interested in learning more about ileostomy alternatives, or if you would like to schedule a procedure, please contact The Center for Ileostomy Surgery at Olympia Medical Center today.