Topic Explanation
The forum topic "What is an Internal Pouch for Crohn's with a Stoma?" revolves around a user with Crohn's disease and a stoma inquiring about the possibility and implications of converting to an internal pouch. The user seeks to understand what an internal pouch is and whether it is a viable option for someone in their condition.

Advice and Insights from Replies
1. General Suitability and Risks:
- An internal pouch is typically not recommended for individuals with Crohn's disease due to the high risk of complications. The pouch is created from the small intestine and involves forming a stoma with an artificial valve for continence, which is drained using a catheter.
- Multiple users shared personal experiences where the internal pouch had to be removed due to complications such as severe pouchitis or the reemergence of Crohn's symptoms. These complications often led to additional surgeries and loss of more intestine.

2. Pre-Surgical Considerations:
- It is crucial to get a biopsy of the small intestine to confirm the absence of Crohn's disease before considering this surgery. Even with a biopsy, caution is advised as diagnostic errors can occur, leading to severe consequences post-surgery.

3. Alternative Situations (Non-Crohn's related queries):
- For individuals with rectal cancer, the feasibility of an internal pouch depends on the condition of the sphincter muscle. If the sphincter is removed or involved in the cancer, forming an internal pouch is not possible as it requires the sphincter for continence.
- In cases where the bowel can be reconnected and the sphincter is intact, a low resection might be performed, sometimes with the addition of a pouch to aid continence. However, this is rare and specific to individual surgical outcomes.

4. General Advice on Pouches:
- While internal pouches can restore a more normal bowel function, they come with risks such as stenosis, pouchitis, and potentially low capacity, which might require further surgeries. These risks should be carefully considered when evaluating this option.