Exploring Alternatives to Jpouch After Small Bowel Surgery

Hi everyone

I had an ileostomy for several years. Recently however, a hernia grew strangling a portion of my small intestine, the small bowel had to be cut 70 cm due to complications.

According to my surgeon, having a jpouch with big piece of small bowel cut out.

She recommended another procedure where the small intestine is joined together with the portion of the large intestine that still is remaining (the stump)

I wanted to ask the forum if anyone has any experience with the alternate procedure and could comment on it.

Also has anyone had jpouch with portions of their small bowel cut?

Thank you

Just wanted to wish you good luck with everything. 🌻

Hi Berket, I had this proposal: 1) Direct connection. 2) Koch Pouch with a valve in your belly. The small intestine is connected to the valve. It empties with a catheter. 3) The J-Pouch. This will work, generally, for a limited period (just me?). Pouchitis is a chronic bacterial infection and if you get it, it spells the eventual end for the J-Pouch. I got a good 7 or 8 years of good times and another ten of varying pain and suffering! The J-Pouch is a risk but you might get lucky. The fear is that you end up with Short Bowel Syndrome which means tube feeding for life! Because they have to use a part of the small intestine still there to create the J-Pouch located down behind your pubic bone. I had some very good years before it failed.

No matter what, you will be wearing a diaper for a year at least. A nephew in Chicago had the direct hookup and he was pretty miserable for a long time...liquid poop all the time, day and night for a year at least. Haven't heard how it ended, I'll ask him how it progressed.

The Koch Pouch is very specialized and is patented so it is very expensive, insurance might not cover it. I went to a specialist in Kings College London and he advised against the Koch Pouch. He wouldn't try to fix the J-Pouch once it starts to fail...Huge risk of short bowel because of more lost small intestine.

I got the permanent ileostomy and am now pain-free and relatively happy 😊☘ in dealing with. These surgeries take years of your life and pain and suffering. Personally, after the J-Pouch experience, I myself would not do the direct connection. Your small intestine cannot absorb liquid like your colon. You are depending on the small intestine to function as a colon and hope it will absorb liquid and stop the liquid poop. If it does, it will take a long time. The J-Pouch surgical technique may have improved...I'm not sure but it's probably the same procedure I had with little difference. It's a hard decision and they have good reason to not want to do the J-Pouch.

Your only options would be the direct connection or ileostomy. I'll ask my nephew how his direct connection is working now and post it.

Hope I was of some help ☘🙂Magoo

Internal ileostomy can also be called

KOCK pouch - named after Dr. Nils KOCK (has passed on)

BCIR - a revised version of KOCK pouch by Dr. Barnett

T-pouch - newest type of revision by Dr. Andreas Kaiser - City of Hope, Duarte, CA.

Many doctors do these internal ileostomies. My family has the FAP gene - several have versions of these and the J-pouch. In fact, my son is getting a J-pouch at the end of August. I have a permanent ileostomy - hopefully getting a T-pouch later this year.