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Surgery Question!

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Ulcerative Colitis
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Posted 4/17/2013 10:35 AM (GMT 0)
I just heard something today that has confused me. If somebody has their entire colon removed, does that mean that they will have a bag for life? I thought people who have the surgery always get their entire colons removed and then after a few months the j pouch is created using the small intestine? I know people can opt for the bag for life but why would somebody have no choice and have to have a bag? Is it because the disease is too bad or something? Very confused!
Posted 4/17/2013 11:08 AM (GMT 0)
Some people may opt for the bag if their J-Pouch failed or have incurable pouchitis. I know CD people can't have a J-Pouch because the risk of fistulas. That's why I'd make sure I have UC before I go with a J-Pouch.
Posted 4/17/2013 12:17 PM (GMT 0)
Surgery for UC involves removing the colon and the rectum. As stated, some prefer to have a permanent ostomy instead of going for a jpouch. Both options have compromises and it's what you're willing to live and deal with which determines which surgery you choose.

Sue
Posted 4/17/2013 1:03 PM (GMT 0)
A jpouch is not offered for *confirmed* (or strongly suspected) crohn's disease, including crohns colitis (crohns restricted to the colon), by most of the leading surgery centers such as Mayo and Cleveland Clinic- however the are places that will offer it if the patient insists, since crohns roughly doubles the chance of pouch failure but doesnt mean it will happen. Also, note that there is no thing about being "certain" that one has UC and not crohns going into or even after surgery. Around 10% of positively confirmed, certain UC cases after surgery eventually turn out to have been crohns- though, again, that doesnt guarantee pouch failure if a jpouch was opted for. As Suebear says, there are pros and cons with both setups but the vast majority of people with either live a vastly superior quality of life than having active IBD.

Post Edited (Probiotic) : 4/17/2013 7:06:03 AM (GMT-6)

Posted 4/17/2013 1:34 PM (GMT 0)
Thanks everyone - thats what I thought! The person that said it was actually misinformed which confused me.
Posted 4/17/2013 3:43 PM (GMT 0)
I had my ileostomy surgery way back when j pouch surgery was in it's infancy (I was 10 years old). My rectum and anus were left initially in the hopes of j pouch surgery but were removed a year later as they were too inflamed. Nowadays, they would just scrape out the rectal lining and then give me a j pouch but back then the technique was unknown.

Having said that, if I still had my rectum and anus nowadays, I'd have to think VERY hard about converting to a j pouch. An ileostomy is VERY liveable and I've grown up with it and am used to it. I don't think I would have j pouch surgery, given the option, because of this. I'm happy with my ileostomy and would hate to do anything to upset the equilibrium.

I know many people nowadays do opt for the bag because they can't bear the thought of a) ever going to the loo in the 'normal' way again as it's caused them too much grief for too long and b) they're happy with just having one surgery and realise that an ileostomy will give them their quality of life back and don't want to bother with more surgeries to create a j pouch.

Either option is fine. It's all up to what you're prepared to go through and live with.
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