The Barnett Continent Intestinal Reservoir (BCIR) is an innovative alternative to the traditional ileostomy. Instead of using an external appliance, the BCIR involves creating an internal pouch to store stool, which is then drained several times a day using a catheter through a small opening in the skin. Here are some insights and advice about the BCIR:

1. Information Sources:
- You can find more details on the official website: www.bcirostomy.com and their FAQ page at www.bcirostomy.com/faq.php.
- The BCIR is an advancement of the original Kock pouch design.

2. Patient and Clinician Experience:
- A nurse shared experiences with three Kock-pouch patients: two were successful, while one failed due to undiagnosed Crohn’s disease. It's important to note that BCIR and Kock procedures are generally not recommended for Crohn’s patients.
- Another individual was approved for the BCIR in 1999, which cost $40,000 at the time and was only available in St. Louis, Missouri. Unfortunately, insurance changes led them to have a standard ileostomy instead, a decision they still regret.

3. Technical Considerations:
- The BCIR features an improved valve mechanism compared to the Kock pouch, which is reported to be virtually leak-proof.
- Surgeons might be cautious about performing the procedure because it requires sacrificing a significant length of the small intestine to construct the valve.
- There is a practical concern about how well the system works if the patient consumes large amounts of roughage, which might not pass easily through the catheter.

4. Practical Advice:
- It's a good idea to discuss the BCIR option with your surgeon. Asking questions is free, and the worst that can happen is being told it’s not suitable for you.