Topic Explanation

The forum discussion revolves around a user contemplating an ileorectal anastomosis (IRA) after living with an ileostomy for nearly 30 years due to Crohn's disease. The user has developed a parastomal hernia, and the colorectal surgeon has suggested an IRA as a potential solution. The user is seeking advice and experiences from others who might have undergone similar procedures after a long period.

Advice and Insights

1. Decision-Making and Risks:
- Consider the long period of non-usage of the colon (30 years) and its potential impact on functionality.
- Age can be a factor in healing and complications.
- Research the success rates and complications of IRA, especially after long periods of non-use.
- Understand that Crohn's disease is lifelong and can affect any part of the GI tract, making surgical outcomes unpredictable.

2. Personal Experiences:
- Some users have heard of successful IRA after 20 years, but each case is unique.
- One user had a reversal after 10 years and was happy with the outcome.
- Another user shared their experience of having an IRA after a shorter period and emphasized the importance of pelvic floor muscle functionality.

3. Medical Considerations:
- Ensure thorough discussions with the surgeon about the specifics of the remaining colon and rectum.
- Consider the potential for Crohn's to reinitiate at the anastomosis site.
- Be aware of the role of the colon in absorbing fluids and bile, and how limited colon length might affect this.
- Discuss the potential for scar tissue formation and its impact on future surgeries.

4. Second Opinions:
- Seek multiple medical opinions to get a comprehensive understanding of the risks and benefits.
- Ensure that the surgeon provides a clear picture of life post-reconnection, including potential challenges with hydration and bowel control.

5. Body Image and Quality of Life:
- Understand the desire to improve body image and the psychological impact of living with an ostomy.
- Weigh the potential benefits of improved body image against the medical risks and quality of life post-surgery.

6. Community Support:
- Engage with others who have undergone similar procedures for support and shared experiences.
- Utilize forums and support groups to gather more information and personal stories.

7. Practical Considerations:
- Be prepared for the possibility of reverting to