What is an Internal Pouch for Crohn's with a Stoma?

hi i have chrons and also have a stoma i read in somebody's profile about converting to an internal pouch could any body explain to me what it is many thx jcray

A diagnosis of Crohn's disease usually excludes someone as a candidate for an internal pouch.  The internal pouch is created from a small portion of small intestine being cut open on one side and then sewn back on itself to create a pouch.  A stoma with an artificial valve is created for continence and a catheter is used to drain the pouch.  I myself have Crohn's disease and in the 1970s I convinced the gastroenterologist and surgeon to perform this surgery anyway.  It ultimately turned into the worst possible decision to make.  Within a year or 2 the pouch had to be removed because of Crohn's.  So I would definitely say do not go with this option even if you can find a surgeon to do it.

thx for your reply most appreciated cheers

dwcinnc is correct.  I have had folks with pouches to later  to find the diagnosis was in fact Crohns rather than UC...another surgery to take dwn the pouch, more intestine lost.



Hopefully this will change one day soon .

That happened to me whoa, my internal pouch had to be taken down due to severe pouchitis. My first surgery was in May of 1984 to form the internal pouch, then 3 months after letting it heal, the second surgery was performed and the temporary ileostomy was removed and I was hooked up. Ready and very anxious to get on with my life as we should be. Three years later the problems came along and before you knew it, I was back in the operating room again for the take down, soo sad!! The only thing my surgeon said to me was that he would have never done that type of surgery on me if he knew what was going to happen and that my small bowel looked very clean during the first surgery. Get a biopsy of your small intestine before you decide to have the internal pouch and then get maybe another opinion. Do not have this type of surgery unless you know for sure it is not Chrons. Even that you gotta be careful. My biopsy said it was inclusive for chron's. I dont have chron's. I have had no problems since the permanent ileostomy was constructed in 1990. I can only think that my pouchitis was not properly treated in west texas by that little indian doctor I saw. Oh well, live and learn my friends.

Words of Encouragement from Ostomy Advocates I Hollister

does any know if you can get the internal pouch if you have been diag. with rectal cancer

m-fran21

when you have an internal pouch they have to use the sphinter muscle of the rectal area to connect with one end of the small intestine in order for the pouch to work normally. If the rectum has been removed like I assume it is, then there would be nothing left to hook the pouch up to. I would do some research on it, but I think I am right on. The internal pouch allows a person to go to the bathroom "normally" but it certainly can fail as I found out.

m fran-21

Hi.  If the sphincter is involved/removed, then one is not a candidate for an internal pouch.  You would not have any stool control/continence without it.  If the sphincter is not affected, the gold standard is to reconnect the bowel with a low resection whenever possible.  I have only had 2 patients over 18 years where the surgeon was able to reconnect the bowel, PLUS added a pouch to help continence.  Otherwise, it is a straight connection, no pouch  OR a permanent colostomy and rectum removed.



If you have sigmoid or descending colostomy, irrigation for bowel control may be an option (though not a necessity).  



I'm not sure if all your questions are answered.





Feisty, you are not alone in having your pouch removed for reasons other than Crohn's finding.  Continent pouches are wonderful, but can also have stenosis, pouchitis, low capacity requiring more surgery.  Something to consider when offered the option of a cotninent pouch  are potential problems and need for  further surgery for some.

hi im  a 51 year old male from the UK

i have a sigmoid colostomy, cause by perforation from diverticulitis...

i am looking at the internal pouch, as an alternative, my surgeon does not perform this procedure, can you see any reasons why this surgery will not be performed, and where i might inquire...  look ford to your reply..

Hi, I live in london, I have had my colostomy for 7 years now. If you would like to chat I or just rant I have a very good ear. Tricia.