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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What You Need to Know About a Failed J-Pouch?

August 25, 2015  ·  By: MD

The J-pouch design helps those who suffer from Ulcerative Colitis or Familial Polyposis to live bag-free, but are there risks of this innovative surgery? The J-pouch is the traditional intervention, but when the procedure fails, it can have life-threatening consequences. Making smart health choices means being informed, so consider how a failed J-pouch can affect your life and what other options are out there.

What is a J-Pouch?

A J-pouch is an internal reservoir surgically created to hold stool. It utilizes the ileum, or end of the small intestine, and the anus. During the procedure, the terminal ileum is sewn back onto itself to form the letter “J.” This design allows patients to still eliminate waste via the anus, as opposed to having to drain it using a catheter or emptying an external bag.

While there are many advantages to this surgical option, it does come with potential complications.

What Happens When the Pouch Fails?

A J-pouch is supposed to give the patient more control, but when it fails, the opposite happens. Stool leakage occurs that can have medical consequences.

  • Pelvic sepsis – Infection that can lead to death
  • Skin irritation – Leaking stool irritates the skin and increase the risk of infection
  • Small bowel obstruction – Small bowel obstruction occurs in 15 to 44 percent of patients that undergo this procedure.
  • Pouchitis – Inflammation of the reservoir
  • Fistulae – tracts from the pouch to the skin that can require surgery

 

Correcting a Failed J-Pouch

The Barnett Continent Intestinal Reservoir, or BCIR, is one procedure done to replace a J-pouch that is causing problems. With a BCIR, the surgeon creates a nipple valve that connects to a small stoma on the lower abdominal wall. The valve is made from the patient’s own tissue using part of the small intestine. A small bandage covers the flat stoma to absorb mucus.

With a BCIR, the patient no longer eliminates waste via the anus. Instead, he or she catheterizes the reservoir 3-5 times a day to remove stool. The BCIR gives the patient the same control as they get with a J-pouch, but without the complications that come if that pouch fails. The BCIR also works when the anus must be removed due to disease or trauma.

A BCIR gives you the freedom to go long periods without emptying the reservoir and can be an answer for those who are tired of dealing with a J-pouch that fails regularly.

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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