"Will I have to wear the colostomy bag the rest of my life?" That’s usually the first question patients ask when discussing a conventional ostomy.
And while it would be great if there was a definitive answer, its truth is, it depends. Many variables play into an ostomy reversal. Fortunately, if you are a candidate, many options will help you maintain fecal continence.
Most importantly, a patient must be in good overall health. That’s because the procedure requires a surgical procedure followed by several days in the hospital.
Reversing an ostomy may depend on why you had it performed in the first place. If you had a temporary ostomy while being treated for colorectal cancer, the procedure can be completed when your chemotherapy or radiation treatment is finished. The procedure is fairly straightforward, requiring an only small incision and short recovery time.
if you had an "end" ostomy, which is intended as a permanent solution, you can have it reversed. The procedure will require a bigger incision and longer recovery. And if you had your colon removed due to ulcerative colitis or Crohn’s disease, you will need to identify a viable option to remove waste.
Several solutions replace a colostomy bag while allowing a patient to maintain bowel continence. All of these options eliminate the need for an external pouch. Instead, waste is stored inside the body in a reservoir that’s emptied several times per day.
A Kock pouch is located on your abdomen. A stoma is created on the surface of your skin, and your small intestine is connected to the stoma. The stool is stored in a reservoir between the stoma and the opening of your small intestine. You’ll need to remove the stool several times a day using a catheter.
A J Pouch works much like a Kock pouch, but it’s located in the anus. You’ll have to empty the pouch several times a day using a catheter. Unlike a Kock pouch, you’ll have up to an hour to empty the reservoir from the time you feel the need and the time the reservoir leaks.
Unfortunately, both the Kock and J Pouch can leak, causing problems for patients. Many opt for a BCIR which offers better control and more convenience. The BCIR is quite similar to the traditional Kock pouch in that it’s located on the lower abdomen and you empty the reservoir using a catheter. However, the stoma is made differently, creating a self-sealing valve which isn’t as prone to leak. With a BCIR, patients go hours between emptying the reservoir and can sleep through the night without worry of leakage.
To learn more about any of these options, contact the office of Dr. Don Schiller, an expert ileostomy surgeon.