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ileo rectal anastomosis

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Ulcerative Colitis
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Posted 10/29/2010 10:06 AM (GMT 0)
I have ulcerative colitis and have recently developed a stricture in my proximal descending colon. Biopsies from a colonosocopy and a CT vitual colonoscopy show there are no tumours or dysplasia and i am well with regular bowel movements. But I have been recommended to have an ileeo rectal anastomosis. Obviously such an operation could mean more stool movements and possibly dietary issues. Would love to hear from anyone who has had such an operation and how they have coped (pluses and minuses)

Thank you

 

Posted 10/29/2010 1:18 PM (GMT 0)
I would see another CR surgeon, preferably one with recommendations from those who had UC. An ileo rectal anastomosis is not recommended for those with UC because the UC will come back in the rectum. What you should be considering is an ileo anal anastomosis with a jpouch. You can meet jpouchers at www.j-pouch.org and get surgeon recommendations in your state.

Sue
Posted 10/29/2010 2:20 PM (GMT 0)
Thanks Sue ..yes I have seen a number of specialists and 2 surgeons and all say I should not be going pouch rote because my rectum is clear ..but I will nead an annual sigmoidoscopy to check rectum.  Because there is no dysplasia or tumours I could still go drug route.
But would like to hear from anyone who has had an ileorectal anastomosis .. that will help m decide whether too the drug route or have the operation

 

Posted 10/29/2010 3:03 PM (GMT 0)
There is a guy who used to come to this site who had the IRA surgery a year or two ago; I don't remember his name though. He is doing well. There is a woman at www.j-pouch.org who had the IRA surgery but after about 8 years she went to the jpouch due to rectal disease. You might post a note over there and inquire.

Sue
Posted 10/29/2010 3:39 PM (GMT 0)
From our surgical consult for my daughter who is a young child with UC I learned that an IRA results in better control and fewer bowel movements (2-3) a day because of the fact that the rectum is left in place. However, if the rectum is diseased then it's not going to work. The surgeon we spoke to suggested an ileostomy for a year or two (what we want, don't know if he felt that would be necessary) giving a chance for the rectum to heal. If it was "in good shape" (don't know what that means really) then we would go ahead with the IRA if we wanted. Otherwise, J Pouch. Basically, he felt if it is possible IRA is a better choice than J pouch but it often is not possible in those with UC. ?
Posted 10/29/2010 10:40 PM (GMT 0)
Thank you for that ... anyone else know about IRA surgery ?
Posted 10/30/2010 9:59 AM (GMT 0)
Another thing to consider, the IRA works great in kids for some reason but not so great in adults. In younger kids, the bowel seems to adapt to do the job of the removed rectum so they can 'hold' the stool for a while, but it doesn't adapt so easily for adults and they often find themselves running to the loo many times a day because they can't 'hold' it in. I've known quite a few who got fed up with it and ended up with an ileostomy.
Posted 10/30/2010 10:20 AM (GMT 0)
Shaz, Thanks for adding that. I thought IRA was mostly used for children too, but the surgeon we consulted was an adult colo-rectal surgeon specializing in IBD and he was referring to the success some of his adult patients had had. I didn't ask too much about it as it would be a decision for us in the future if we get to surgery but it did cross my mind. To the OP, when you say your rectum is "clear" do you mean it's clear of inflammation? Is that possible with UC as opposed to CD? I'm asking because we tried to ask the surgeon how her rectum would be in good enough shape for an IRA since UC starts at the rectum and I assumed that leaving the rectum in would mean leaving the diseased intestine in? I think he responded that we would leave it and see if it would heal enough to do an IRA.
Posted 10/31/2010 9:03 AM (GMT 0)
Check out a new option for colorectal anastomosis at www.nitisurgical.com.
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