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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Looking at your Ostomy options and life afterwards

January 23, 2015  ·  By: MD

An ostomy is a surgery to bring part of your intestine through the abdominal wall to the skin to allow for the evacuation of intestinal digestive waste.  This type of surgery can be needed if your large intestine is no longer healthy and functioning normally.  Examples of ostomy options include a colostomy, ileostomy and urostomy.  People with an ostomy look into the possibility of ileostomy or colostomy reversal, to restore the normal passage of waste, or to avoid the need to wear an external appliance or pouch.

 

Various surgical options have their own pros and cons.  Your doctor can discuss your ostomy options with you to make sure you have the right procedure for your situation.  In addition, you can discuss what to expect after your ostomy as you return to normal life while caring for this new condition.

 

CONVENTIONAL ILEOSTOMY (BROOKE ILEOSTOMY)

 

A conventional or Brooke ileostomy requires you to always wear a collecting bag over the stoma.  You can hide it under your clothes, but it drains continuously and you cannot stop the flow.  Also, to help prevent food blockages, a low roughage diet can help.  This however may not be healthy as it restricts the eating of fruits and vegetables.

 

IPAA, ILEOANAL J POUCH, or J-POUCH

 

This procedure involves removing the entire large intestine (colon) and rectum as with Ulcerative Colitis,

but preserves the anal canal and sphincter muscles.  A pouch is created from the small intestine and connected to the lower rectum.  While people can evacuate normally after this operation, they usually have between 4-7 bowel movements per day, and can only wait up to one hour once the urge to go occurs.  Also, problems can occur with lack of control (continence) with leakage out of the anal opening.

If you have a failed J-pouch procedure, it can be converted to the internal continent ileostomy.

 

BARNETT CCONTINENT INTESTINAL RESERVOIR (BCIR) – BARNETT VERSION OF KOCK POUCH

 

This type of internal continent ileostomy has the advantage of greater control of waste elimination, and freedom from wearing an external bag and from any skin irritation.  In this surgery an internal pouch made from the small intestine with a valve (also made from your small intestine) connects to a small ostomy opening low on the abdominal wall.  The BCIR is self-sealing so no waste or gas gets out until you drain it by painlessly inserting a small catheter (tube) and letting it flow into the toilet.  The BCIR has allowed for many patients to enjoy a higher quality of life when compared to other ileostomy procedures.

 

LIFE AFTER AN OSTOMY

 

Life after an ostomy can often continue similar to before, including sports and physical activities.  Following an appropriate healing period after surgery, a normal level of activity vcan be resumed.  Your diet will ultimately be unlimited, but may need to be adjusted in the early months after your surgery.

 

Contact Dr. Schiller today to discuss ileostomy options and life afterwards.  A good ileostomy specialist truly is just that – a specialist.  That means the physician spends most of the time doing these types of operations, not once in a while.  It also means the surgeon has had sufficient years of experience to provide the most comprehensive care.  You want to make sure your surgeon will spend time with you after your operation, while you are in the hospital and after discharge as your ostomy is maturing and healing, and provide personalized follow-up care and be available to 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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