Deciding whether to go ahead with internal pouch surgery after having an emergency ileostomy can be a tough choice. This situation often arises for people who have had to deal with long-standing ulcerative colitis. One person shared their experience of having an emergency ileostomy earlier this year. Although they developed a serious infection six weeks after the operation, they are adjusting to life with a stoma. Their surgical team has scheduled an internal pouch construction for late June, but they are unsure about proceeding and are seeking advice from others who have been through similar experiences.

Here are some insights and advice shared by the community:

1. Do thorough research before making a decision. This includes reading patient blogs, medical literature, and seeking multiple medical opinions. The specific design of the pouch, such as a J-pouch or K-pouch, can affect the risks involved.

2. Listen to both experienced ostomates and doctors. Many people find that real-life user experiences provide a more candid view of the daily realities and potential complications.

3. Some people feel that an external pouch (standard ileostomy) is safer because:
- There is a lower risk of internal leaks or failures that might require further surgeries.
- There are fewer reports of severe complications compared to internal pouches.

4. Others report a good quality of life with an internal pouch but also acknowledge that many people live comfortably with a permanent bag. The choice is personal and should be made without pressure.

5. Waiting is often recommended:
- Allow your body and mind to fully heal after emergency surgery before considering elective reconstruction.
- There is generally no time limit; takedown surgery has been successfully performed even 18 years after the initial ileostomy.

6. Seek a second surgical opinion specifically about:
- Expected function, such as stool frequency, urgency, and nighttime control.
- Potential complications, including pouchitis, fistulas, seepage, and raw skin around the anus.
- Impact on lifestyle and future corrective options.

7. A cautionary personal account was shared by a member who received both an internal pouch and later a stoma, leading to dual output because the pouch wasn’t fully disconnected. They experienced chronic perianal soreness, repeated leaks, pancaking, multiple surgeries, and depression. The lesson here is to ensure that surgeons clearly explain procedure details and possible long-term outcomes.

8. A practical tip for current stoma care: Keeping a few sheets of white kitchen roll under and over the bag can catch early leaks and reduce laundry.