This topic is about exploring options after a "temporary" ostomy has not gone as planned, leading to persistent leakage and complications. The person involved is considering a J-pouch or other solutions after facing challenges with their current situation. Here are some pieces of advice and insights shared by others:

1. Consider finding a new colorectal or IBD specialist:
- It's important to change surgeons if you feel a lack of trust or competence.
- Some have recommended a colorectal surgeon at Vanderbilt Hospital in Nashville.
- Others have had positive experiences with a colon-rectal specialist at Gessler Clinic, Winter Haven Hospital in South Florida.

2. Don't hesitate to seek multiple opinions. Doctors are generally understanding when patients decide to transfer their care.

3. For those dealing with flush or retracted stomas, Coloplast convex barriers (soft, light, or full) can be helpful. The full-depth convexity is specifically designed for stomas below skin level and can significantly reduce leakage.

4. Consider irrigation even if you've had radiation:
- Some individuals with a history of radiation have successfully used irrigation to gain a sense of normalcy.
- While slow bowels might extend the time needed for irrigation, medications like Domperidone can help with bowel movements.

5. Explore continent alternatives:
- The BCIR (Barnett Continent Intestinal Reservoir) is an option performed by Dr. Rehnke at Palms of Pasadena Hospital in St. Petersburg, FL. They offer free literature and a CD/DVD for those interested.

6. Weigh the options between a J-pouch and a permanent ostomy:
- Some surgeons may advise against a J-pouch or reversal after radiation or cancer, but others have noted successful permanent ileostomies without issues like urgency or pain.
- It's crucial to thoroughly research surgeons' experience with J-pouches in patients who have undergone radiation before making a decision.

7. Always verify the credentials and experience of surgeons online. Incompetent or overly confident advice can lead to preventable complications.