Topic Explanation

The discussion centers around a person named Scot who had their colon removed due to long-term ulcerative colitis (UC) and Crohn's disease. Despite the successful functioning of their ostomy, they are experiencing inflammation and leakage from the rectum, which is perplexing to their surgeon. This issue is preventing them from getting a J-pouch, a surgical procedure to create a new rectum from the small intestine. Scot is seeking advice and feedback from others who might have experienced similar issues.

Advice and Insights

1. Consider Complete Removal:
- Several participants suggest considering the complete removal of the rectal stump and opting for a permanent ileostomy. This is recommended to prevent ongoing inflammation and complications associated with UC and Crohn's disease.

2. Ken Butt Surgery:
- The option of "Ken butt" surgery, which involves sewing up the anus after removing the rectal stump, is recommended. This can potentially improve the quality of life by eliminating the source of inflammation.

3. J-Pouch Concerns:
- There is a consensus that a J-pouch may not be suitable for individuals with ongoing Crohn's disease, as it can lead to further complications such as pouchitis and cuffitis. Participants share personal experiences of J-pouch failures and subsequent removal.

4. Quality of Life with Ileostomy:
- Participants express that living with an ileostomy can significantly improve quality of life compared to dealing with the daily issues of IBD. They share positive experiences post-surgery, emphasizing the relief from symptoms.

5. Consultation and Research:
- It is advised to consult with healthcare professionals and conduct thorough research. However, participants note that personal experiences from those who have lived with IBD can be invaluable.

6. Acknowledgment of Ongoing IBD Symptoms:
- Even after surgery, some symptoms of IBD may persist in other forms. Participants share that while surgery can alleviate many issues, it does not completely cure IBD.

7. Personal Experiences:
- Participants share their personal journeys with IBD, surgeries, and the outcomes, providing Scot with a broader perspective on potential paths forward.