This topic is about someone who is considering different surgical options after having an end ileostomy. They have about 10 inches of healthy sigmoid colon left, and they are exploring the possibility of an ileorectal anastomosis (IRA) as an alternative to a J-pouch or keeping the ileostomy. They are seeking recommendations for surgeons and first-hand experiences from others who have undergone an IRA.

Here are some helpful insights and advice shared by others:

1. A member shared a success story from the Cleveland Clinic, where a female colorectal specialist performed an IRA with excellent results. The member had only 8 inches of rectum left, and the surgeon advised against a J-pouch, calling it "malpractice" in their case.

2. It's important to be aware of specialty bias. Surgeons often recommend the procedure they are most familiar with. To get balanced advice, consult with surgeons who have experience performing IRAs.

3. Consider the quality-of-life trade-offs. If the ileostomy is functioning well, some suggest it might be best to leave it as is. Surgery carries risks, and the comfort and peace of mind with a stoma can sometimes outweigh the potential benefits of reconnection.

4. Be cautious about J-pouch surgery. It's not always a guaranteed solution. Some members have experienced chronic pouchitis, fistulas, skin irritation, and in some cases, a return to a permanent ileostomy. There are reports of serious complications, including one case where a person developed an anal-vaginal fistula and another where someone died from post-operative complications.

5. If you have Crohn’s disease, it generally excludes you from being a candidate for a J-pouch or IRA. Make sure your diagnosis is confirmed as ulcerative colitis before proceeding.

6. There are community resources available. A user named "Colin Sans Colon" has an extensive thread about IRA in the site's Reversal section, which could be useful. They might also have information on surgeons in the New York area. Members are willing to share surgeon names privately through direct messages.

7. General guidance includes doing thorough research, listing the pros and cons, and seeking multiple medical opinions before deciding on any restorative procedure. Be aware that some complications can arise years later, so long-term follow-up is crucial.