BCIR (Barnett Continent Intestinal Reservoir) - Peer Advice

What is BCIR?

BCIR is a modification of the Kock pouch procedure. In this surgery, a pouch is created from the small intestine. This internal reservoir collects waste, which is then drained several times a day through a catheter inserted into a small, flush stoma (opening) on the abdominal wall. Unlike the conventional ileostomy, where waste continuously drains into an external bag, BCIR allows for control over the evacuation of waste, offering more freedom and discretion.

Why is it Performed?

BCIR is typically performed on patients who:

1. Have had their colon removed due to diseases such as ulcerative colitis, familial adenomatous polyposis, or Crohn’s disease.
2. Are seeking an alternative to a conventional ileostomy, which requires wearing an external bag.
3. Have had issues with previous ileostomies, such as skin irritation, leaks, or difficulty managing the ostomy.

Risks

As with any surgical procedure, BCIR carries several risks:

1. Pouchitis: Inflammation of the internal pouch, often treatable with antibiotics.
2. Valve Slippage or Failure: May require surgical correction.
3. Infection: Risk at the surgical site or within the pouch.
4. Obstruction: Blockage in the intestine or pouch.
5. Perforation: A rare but serious risk where the pouch or intestine may develop a hole, leading to leakage and infection.

Overall Advice

1. Consultation: It’s crucial to discuss thoroughly with a gastroenterologist or a surgeon specialized in this procedure.
2. Consider Lifestyle Impact: Understand how BCIR will impact your daily life, including changes in diet, activity, and routine care of the stoma.
3. Surgical Expertise: Choose a surgeon with extensive experience in BCIR.
4. Post-Surgical Care: Be prepared for a significant recovery period and follow-up care, including learning how to care for the stoma and use the catheter.
5. Long-term Monitoring: Regular check-ups are necessary to monitor the health of the pouch and address any complications early.

Here are some tips and insights from the MeetAnOstoMate Discussion Forum regarding the BCIR procedure:

- Candidates for the BCIR procedure include those with conditions such as ulcerative colitis, Crohn's disease, other forms of inflammatory bowel disease, familial adenomatous polyposis (FAP), and those with failed j-pouches.
- Risks and contraindications for the BCIR procedure include colostomy, Crohn's disease, obesity, adaptive needs or intellectual disabilities, and short bowel syndrome.
- Complications of the BCIR procedure include bleeding, leakage, perforation, necrosis, valve slippage, prolapse, fistulas, volvulus, hernia, valve stenosis, and pouchitis.
- The success rates of the BCIR procedure vary, with some studies showing high functional pouch rates after one year, while others indicate a significant revision rate.
- Aftercare for the BCIR procedure involves carrying a tube to empty the pouch, and patients may experience pouchitis, which can be managed with antibiotic treatment.
- The BCIR procedure is not common and is usually only done for highly motivated patients who are good candidates, and it may require traveling to a specialty center for the surgery.

If you have further questions or seek more detailed advice, consider posting your question in the discussion forum of MeetAnOstoMate.org for personalized insights.

Check out these links for more information:

• BCIR Procedure: Seeking Advice and Experiences (September 16, 2019)
• Experiences with BCIR surgery? (January 27, 2020)
• BCIR or Not? Seeking advice on ileostomy alternatives and experiences. (July 21, 2014)
• Opinions on BCIR surgery for ileostomy patients? (March 18, 2012)
• BCIR Procedure vs. J Pouch: Experiences and Advice? (June 02, 2012)
• Seeking BCIR surgery experiences after colon removal (November 05, 2011)
• BCIR Surgery Availability in England? (February 09, 2016)
• Seeking Info on BCIR (Barnett Continent Intestinal Reservoir) (March 21, 2014)
• Hole in Stoma, Need Advice! (January 15, 2014)
• GI Symptoms in Colon-less Individuals: Seeking Advice (April 08, 2019)