koch or pull through vs. j pouch
Question:
The third stage of my j-pouch will be fairly soon, and yes I have had complications in the surgery, but I’m fine now. I’ve heard lots of good reports and a few bad. Can’t tell you any more really but take a look at www.j-pouch.org. Mark.
Response:
I’m a married, nearly-40 male with three little kids, and I had to have surgery for my UC last fall because I developed a bit of dysplasia in my colon. Barbara Skogland’s post on this thread has it right that it is absolutely a matter of what’s important to you. The two most common procedures seem to be J-pouch or traditional ileostomy; I hear that the Kock pouch is less common and more fraught with complications, but I don’t know enough to say much more than that. In the studies I’ve read, as well as the postings in places like this newsgroup, the overwhelming majority who take either the J-pouch or the traditional ileostomy are extremely happy with what they chose. I don’t consider myself vain about my appearance, but I didn’t want to have an ileostomy. I wanted to look "normal" for my kids and for myself. I also didn’t want the hassle and dependency on special equipment. And I didn’t want to have to worry about the possibility of a bag leaking without any notice (though longtime ostomates become so expert that leaks become only a very minor concern). Either a J-pouch or an ileostomy can have minor, nuisance complications, as well as complications requiring further surgery. If I recall my comparative statistics correctly, the J-pouch complication rates seem to be 2-3 times as high. For that reason, I was very selective about my surgeon and went with the most conservative one I could find. I had my J-pouch done as a 2-step operation, with a temporary ileostomy for the 3 months in between. (This is common practice.) During the period right after the J-pouch is hooked up, you would be going to the bathroom about 10-12 times/day. Gradually, as the pouch stretches over the next year or two, that decreases to 3-5 times/day. You may be taking something like Imodium to help thicken and control it. From virtually the beginning, most people have very good bowel control, with the ability to hold stool in for a good while, though a small percentage of people have minor "leaks" during the day or overnight. Many of the people who choose an ileostomy do so because they’re tired of having to rush to the toilet and don’t want to deal with the adjustment the first year. Others say they don’t want to deal with any more surgical complications. My own main complication has been "pouchitis," which has responded well to antibiotics. I’m very happy with my outcome so far. I feel perfectly normal. And I feel that I made the right choice for me. Good luck, and keep asking questions. Sam – Hide quoted text — Show quoted text – >Looking to hear from people who have had or know people who had ulcerative >colitis that have had either of the two surgeries. Such issues as initial >recovery and adjustment to long term ect. From what I’ve heard and read there >can be many complications with j pouch, but after nine months to a year things >improve. Would welcome all feedback.
Response:
Looking to hear from people who have had or know people who had ulcerative colitis that have had either of the two surgeries. Such issues as initial recovery and adjustment to long term ect. From what I’ve heard and read there can be many complications with j pouch, but after nine months to a year things improve. Would welcome all feedback. Thanks.
Response:
In making these kinds of surgical decisions it is best to sit down and list your priorities. Is your # 1 priority "least amount of complications and need for more surgery" then an ileostomy is your choice. If your #1 over riding priority is shitting "normally" then the j-pouch is the way to go. Both the Koch and BCIR have higher failure rates and revision needs than do the j-pouch or an ileostomy. How does cost factor in? Most insurance companies won’t cover BCIR surgery and it is the most expensive of the options. Most people are satisfied with the decision they made for themselves. So many people tend to advocate for the decision he/she made. Each of us have different issues that led us to our decision. I’d suggest that you make a list of what’s most important to you. Use the feedback you get from people’s personal experience — but remember that you are unique and you need to decide what is best for you. I tried to have a j-pouch, but my blood vessels wouldn’t reach to feed the pouch so my first Dr. gave me a straight shot. Basically I had an ostomy out my ass since with no holding tank I went to the bathroom as much as I did with a major UC flare. After 3 years I had a permanant ileostomy installed. My life is 100% – no a million % better. I am very happy with my decision and my life is much more "normal" with an ileostomy than with the straight ileal-anal anastimosis I had. Although I did research the Koch and BCIR I never saw either as a viable option for me for many reasons. Good luck as you make your decision. Barbara Skoglund > Looking to hear from people who have had or know people who had ulcerative > colitis that have had either of the two surgeries. Such issues as initial > recovery and adjustment to long term ect. From what I’ve heard and read there > can be many complications with j pouch, but after nine months to a year things > improve. Would welcome all feedback. > Thanks.
Response:
Related Posts