The topic at hand is about considering the Barnett Continent Intestinal Reservoir (BCIR) as an alternative to using an external ostomy bag. The person exploring this option currently uses an external ileostomy bag and is curious if the BCIR could be a better fit for them. They are looking for real-life experiences and insights from others who have undergone the BCIR procedure.

Here are some key points and advice shared by others:

1. Concerns and Considerations:
- The need to carry and insert a catheter multiple times a day.
- Managing frequent liquid drainage from the small-bowel reservoir.
- Risk of blockages if the output becomes thick.
- Reliability of the one-way valve and the risk of accidental leakage.
- The desire to improve appearance and hide the bag, balanced against the complexity of the operation.

2. BCIR Overview:
- The BCIR involves creating an internal pouch from about 2 feet of the small intestine, with a stoma that is flush with the skin and covered by a small bandage.
- The pouch is emptied using a catheter 2 to 5 times a day, and sometimes at night.
- Hospital stay can range from 1 to 4 weeks to learn how to care for the BCIR, with an ongoing need to carry catheters.
- Suitable candidates include those with ulcerative colitis, familial adenomatous polyposis, a failed J-pouch, or a strong desire to avoid an external appliance.
- Not suitable for those with Crohn’s disease, an existing colostomy, significant obesity, short-bowel syndrome, or those unable to self-catheterize.
- Early risks include bleeding, leakage, and perforation, while later risks can involve valve issues, fistulas, hernias, and pouchitis.
- A study from 1995 reported that 92% of BCIRs were functional at one year, though 29-45% required revision within a year. Most patients reported satisfaction.

3. Quality-of-Life Perspectives:
- Some members emphasize that learning to manage a conventional pouch can restore a normal lifestyle, and switching to a more complex surgery should be considered carefully.
- Concerns about body image are valid, but the BCIR involves a high-maintenance internal system and potential for further surgeries.

4. Professional Consultation:
- It is strongly recommended to consult with a high-volume colorectal specialist. One recommended specialist is Dr. Thomas E. Read at UF Health Shands Cancer Hospital in Gainesville, FL, known for his honest and experienced advice on BCIR suitability.

5. First-Hand BCIR Experience:
- One member shared a positive experience, stating, "I love my BCIR—best decision I ever made," and provided a YouTube demonstration on how to intubate a continent ileostomy.

6. Limited Surgical Availability:
- There are only a few surgeons qualified to perform and follow up on BCIR procedures, as highlighted by a member seeking a new surgeon after theirs retired.