This topic is about a person who had emergency surgery two years ago due to complications from Crohn’s disease and diverticulitis. They had their entire colon and part of their ileum removed and now live with an end-ileostomy. While they have adapted to this new way of life, they experience some discomfort and anxiety, especially in social situations. Their surgeon mentioned that a procedure called ileorectal anastomosis (IRA) might be possible, but it comes with significant risks. The person is seeking advice from others who have undergone this procedure. Here are some insights and advice for anyone considering this option:

1. Clarify and get second opinions:
- Ask your surgeon to explain why the procedure is considered "very high-risk" and request specific statistics related to Crohn’s disease outcomes.
- Consider getting an independent opinion from another surgeon, especially from a reputable center known for complex surgeries.
- Make sure you are fully informed by being included in all communications and doing your own research before making a decision.

2. Assess Crohn’s status thoroughly before reconnection:
- The success of IRA depends on the current state of Crohn’s disease. Ensure that both the rectum and small bowel are free of inflammation through tests like biopsies and endoscopies.
- Be aware of the high-risk factors, such as the potential for disease flare-ups at the anastomosis site.

3. Understand functional expectations after IRA:
- Be prepared for frequent, often semi-liquid stools after the operation, which can be irritating and will need careful management, especially in the early stages.

4. Recognize IRA is not a Crohn’s "cure":
- Removing the diseased bowel does not eliminate the underlying inflammation, and other symptoms like arthritis or eye problems may continue or worsen.

5. Balance quality of life with stoma versus reversal:
- Many people adapt well to living with an ileostomy. Consider your personal priorities, such as dietary freedom, intimacy, and social anxiety, before deciding on a reversal.

6. Seek support and reliable information:
- Engage with any available support resources, whether local or online, to gather information and share experiences.
- Approach the situation with a positive but cautious mindset, asking many questions and focusing on Crohn’s-specific data.

7. Device-specific caution:
- Be aware that certain devices, like the TIES continent ostomy device, are not recommended for Crohn’s patients in clinical trials, highlighting the need for a tailored risk assessment.