This topic is about a young man, 19 years old, who is facing a tough decision regarding his health. He has been living with an ileostomy for seven years after having surgery for ulcerative colitis and Crohn’s disease. This situation brings him daily challenges like pain, sleep issues, hygiene problems, and social barriers. Now, he has the option to undergo a two-stage J-pouch surgery that might improve his quality of life by removing the stoma and restoring more normal bowel function. However, this surgery comes with significant risks, especially since his Crohn’s disease is still active. Here are some key points and advice related to his decision:

1. The potential benefit of the surgery is a significantly better quality of life for 5 to 10 years, with the possibility of longer. This includes normal showers, comfortable sleep, easier intimacy, and freedom from wearing a support wrap.

2. The risk of the surgery is high, with a 60% chance of success and a 40% chance of failure or serious complications due to the active Crohn’s disease.

3. Long-term risks include a rising chance of severe recurrence and tissue damage each year after the 10-year mark, which could lead to a permanent stoma and possible erectile dysfunction if Crohn’s returns.

4. The decision is difficult: either proceed with the surgery for potential improvements but accept the risk of future complications, or decline the surgery and continue living with the current limitations.

5. It’s important to consider personal emotional and physical tolerance when making this decision.

6. Statistics are helpful but not definitive; focus on how you feel daily rather than just the numbers.

7. Seek multiple second opinions from recognized experts in inflammatory bowel disease, gastroenterology, and colorectal surgery to get a well-rounded view.

8. Stay informed by reading up on current research and emerging treatments that might offer better options in the future.

9. Consider delaying major surgery if your current quality of life is manageable, as new treatments and technologies are continually developing.

10. Some people choose to keep their permanent ileostomy to avoid the risks of further surgeries and potential complications, and they report living active, fulfilling lives.

11. Others opt for the reversal surgery, hoping for a more normal life, showing that personal values and priorities play a big role in such decisions.

12. Be cautious about relying on a single surgeon’s opinion; verify all recommendations through multiple sources.

13. Whatever choice you make, commit to it fully, prepare for all possible outcomes, and aim to live your best life within that decision.