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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Exploring Your Ostomy Options

March 12, 2015  ·  By: MD

If you are suffering from Familial Adenomatous Polyposis or Ulcerative Colitis, removal of the colon and rectum may be required in order to alleviate your symptoms and/or prevent further complications. In such cases, a new method of eliminating waste is necessary. Depending on the specifics of your situation, you may be able to choose from several different ostomy options.

Brooke Ileostomy (Conventional Ostomy)

In a Brooke Ileostomy, the surgeon connects the small intestine to an opening in the abdominal wall, which is referred to as a “stoma.” Waste flows through this opening and into an external collection bag. Although this procedure can effectively treat serious conditions affecting the colon, it does have some drawbacks. Problems with the Brooke Ileostomy include:

  • No control over elimination (continuous flow of waste)
  • External bag must be worn at all times
  • Protruding stoma
  • Potential for leakage, food blockages and other complications
  • Dietary changes may be required

J-Pouch

The ileoanal J-pouch is created when a surgeon uses a portion of the small intestine to create a reservoir, or “pouch.” The pouch is then connected to the anal canal, where waste is released. This procedure eliminates the need for an external bag and provides patients with more control over their bowel movements. However, the J-pouch still has a few disadvantages, including:

  • Many stools (at least 4 to 7 per day)
  • Patients can defer bowel movements for no more than one hour
  • Potential for leakage, pain and irritation

Barnett Continent Intestinal Reservoir

The final option for patients considering an ostomy is the Barnett Continent Intestinal Reservoir, or BCIR. During this procedure, the surgeon uses part of the small intestine to create an internal reservoir with a nipple valve. The valve connects to a stoma located in the patient’s lower abdomen. This procedure offers several advantages over both the J-pouch and traditional ileostomy, including:

  • Complete control over emptying of the reservoir
  • Painless emptying with the use of a small catheter
  • Reservoir must be emptied only 3 to 5 times daily
  • Flat, inconspicuous ostomy
  • Self-sealing valve releases no gas or waste until catheter is inserted

Choosing a Surgical Option

If you are in need of an ostomy, or if you already have a J-pouch or conventional ostomy and would like to explore other options, contact our office today to schedule an appointment. We will be happy to review your medical history, explain your treatment options and help you choose the solution that is best for you.

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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