If you are a healthy individual living with a malfunctioning Brooke ileostomy or ileoanal J-pouch, there is a better way. The Barnett Continent Intestinal Reservoir, or BCIR, allows those who have had their large intestine removed due to disease, trauma or to prevent cancer, to live bag-free. It is not a full ileostomy reversal, but it is close as medical science can get.
What is an Ileostomy Reversal?
In a normal functioning digestive tract, food travels from the stomach into the duodenum, and then enters the small intestine where nutrients are absorbed. From there, it moves to the large intestine (colon) and eventually is evacuated through the rectum as waste.
During ileostomy surgery, the physician brings the end of the small intestine to the surface of the skin and connects it to a surgical opening called a stoma. An ileostomy reversal attaches the small intestine to what remains of the colon, reconnecting the digestive tract.
For some people, a full reversal is not an option, because during the initial ileostomy, the entire large intestine and rectum were removed. The surgeon must create a new way for this person to eliminate waste.
What is the BCIR?
Developed by Dr. Nils Kock in 1969 (the Kock Pouch) and subsequently modified by Dr. William O. Barnett, the BCIR (Barnett Continent Intestinal Reservoir) frees you from living a life built around the bag. The surgeon creates an internal reservoir using the ileum, the end of the small intestine. A nipple valve also fashioned from the patient’s intestine connects to a small stoma situated at the bottom of the abdomen. With the bag process, waste material flows continuously into an external bag all day, but with a BCIR, it collects in the reservoir until released through a tube into the toilet.
The intubating, or tube insertion, process allows the patient to remove waste as needed, restoring control and convenience to the elimination of intestinal waste. Intubating to empty the pouch is painless and takes only a few minutes.
Dr. Kock’s original pioneering procedure has been further modified over the last few decades, making it an even better option for those facing ileostomy. Today, the hospital stay is about two weeks and includes full training on how to use the catheter. The patient is able to do normal activities with a BCIR, such as exercise, and to live life to the fullest without worrying about a bag.