An ostomy is used when there is an intestinal disease or cancer to the colon, or when the intestinal tract can’t perform properly due to scar tissue or blockage by a disease. Some ostomy procedures are permanent, while others can be reversed.
There are three main ostomy options to eliminate waste following surgery that remove the colon and rectum. The options include the continent intestinal reservoir (CIR), brooke ileostomy, and the ileoanal J-pouch. Here is more information about each type of ostomy so that you and your doctor can work together to decide which is right for you.
Barnett Continent Intestinal Reservoir (BCIR)
The first ostomy option available to you is the Barnett Continent Intestinal Reservoir, or BCIR. This operation, which is an improvement of the Koch pouch, or K-pouch, has been around since the 1980s. During the procedure, the colon and rectum are removed, and a pouch is created using your small intestine and an intestinal valve.
The BCIR procedure has the benefits of not needing an external appliance or bag, control of waste elimination, ability to perform physical activities, and less skin irritation and burning from waste leakage.
The ileoanal, or J-Pouch, leaves the anal sphincter, but removes the rectum and colon. There is an internal pouch that is made using the small intestine and is then connected to the muscles of the anal sphincter. This ostomy procedure has a high risk of complications. It also may require two separate surgeries and requires 4-8 bowel movements a day, which can be inconvenient for some patients. The benefits include the fact that the pouch is internal, it can cure the disease, and there is still the normal evacuation of stool, reports Ostomy.org.
Conventional Brooke Ileostomy
The conventional brooke ileostomy has the lowest risk of complications. It is also the oldest known ostomy. With the conventional brooke ileostomy, the colon, rectum, and anal opening are all removed. There is an opening made in the abdominal wall, where the small intestine is sewn and a stoma of ¾ inches is created. This allows intestinal waste to go into the stoma and the pouch. A permanent appliance needs to be worn with this procedure.
Some benefits are lower rate of complications and the fact that it is a more simplified surgery. The downsides include having an external pouch, some skin and narrowing problems, and needing to empty to the pouch up to 6 times a day.
Please give us a call at The Center for Ileostomy Surgery at Olympia Medical Center, Los Angeles, California to learn about the ostomy options and to discuss which is right for you.