Hey gang,

Me again, seeing my surgeon in five weeks, so I've been researching my options, the most beneficial one being a K pouch. However, I can't seem to find anything on line about it other then a brief description. I was hoping to find a video that shows what it looks like, and how you drain it. Do any of you know of any web pages where I could find detailed info? Just want to know what's involved before I make my final decision. One thing is certain, my J pouch and rectum has got to go, but leaves me with only a few options. One more thing, does anyone know the difference between a K pouch and a BCIR? Thanks, any and all help would be greatly appreciated!!

Cheers!
Eric

Hello Eric,

If you find vanessavy recent posts, she has a video of a bcir (similar to kpouch). Also, if you google kpouch video and bcir video you will find some very informative stuff. I recently found a video of a guy emptying his kpouch. It was great. I will try to find it and forward it to you. It looks like a great option.

youtube bcir drainage. You will find a few videos of actually draining and explaining what a bcir is. don't think there is much difference with a k pouch, but still looking.

This message has been edited. Last edited by: dawn58,

Youtube BCIR.My fried Mike drains his on cam. He also became a pro body builder after his BCIR. My BCIR is rockin'.

Hi Eric,
First off, I honestly believe, that if it is possible, the k pouch (or BCIR) is the best possible option if you have a failed j pouch and do not want an outside bag (it may very well be the only other option).
The major difference between the K pouch and the BCIR is the living collar on the valve which is supposed to prevent most of the problems that the K pouchers are having with it (valve slippage, prolapse...) although my k pouch surgeon uses the living collar on the valve too...most people do not have major problems and live happily with their pouches...intubation is easy (draining of the pouch), you just lube the tube and put it in, not much more complicated than putting a straw into your mouth. You carry the tube around in a ziplock or little pencil case or make-up bag along with a mini packet of lube and a syringe for irrigating if needed...I cover my stoma with a folded kleenex from a mini packet, they are the perfect size and absorbtion for me, I also add a minipad cut in 2 and stuck to my unddies for extra protection (just in case).
Since they have invented the squeeze top water bottle my life has become 1000xs easier...I fill up a mini bottle before entering a public stall and then use it to rince out the tube or irrigate my pouch as needed...so much simpler than filling up a cup and carrying it in or draining the bowl ...
Most of the people who know me don't know anything about the pouch or problem and are shocked to find out that I have a pouch if I tell them. I traveled extensively with my pouch an did tons of physical activities and sports. Life with a pouch is liberating espeically if you have suffered from incontinence or other problems.
PM me if you have any worries or questions and I will be happy to answer.
I have had my pouch for 32yrs and have not lived problem free but I still love it inspite of all of the problems.
Sharon

Eric I give out my number to anyone who wishes to discuss it. Google voice is the bomb to avoid stalkers :-) i'll be honest and tell you how it is. PM me to discuss!

Hi Eric, both the KP and BCIR are continent ostomies. They look and act completely the same except the BCIR has a different valve (collar).

Both empty the internal reservoir the same by inserting a plastic cath into a flat stoma (flush with your skin) that is on your stomach. Some sit on toilet and insert the cath aiming it down into the toilet some stand and empty into a bowl or whatev. You can do whatever is easiest once you get the hang of it. Once you insert the cath poo will flow (it is not painful). You sometimes have to use your stomach muscles or turn a bit to get more poo flowing out. Or, you will need to irrigate using water in a syringe that you insert while the cath is in into the other end to loosen the poo up. And, sometimes if you dont' CHEW CHEW CHEW food, you will get chunks of food that need to be manually pulled out of the cath holes (using a tissue with your fingers) and then insert cath again. This is NOT a blockage, this is just non chewed food trying to exit the pouch.

The stoma is active so some level of clear mucous will omit so some members wear a pad over it. It may be a band aid, peice of gauze, ampatch whatever is needed. Some just put tissue over it and their underpants press against it. It's just wetness not poo.

Both KP and BCIR use plastic caths, either the marlen or medina. The medina is stiffer with a small hole at end and the marlen is pliable with no hole at end. Some feel the marlen uses less trauma day to day inserting it into the stoma past the valve to empty.

The catheter does not have to be sterile (like with urinary caths) so you can just rinse it with regular water. You can keep the cath in a zip lock bag with your lube gel (it helps glide the cath past the valve). It will turn brown as you use it as the poo stains it. Sort of like an ostomy bag.

I am not sure why the Cleveland Clinic only performs the KP, but many members have successful bcirs and kps. It's mainly finding a solid surgeon. I personally feel a colorectal surgeon is best as you may have a complicated case and they should be best equipped to handle it once they open and start surgery.

That is about the best explination that I have heard...thanks Janice.
Sharon

My catheter goes in my flush stoma, no pain....I push the catheter in about 5 inches and then I hit the valve which is made out of intestine, and it doesn't hurt. You feel the resistance and push through the valve, you can put something like a golf tee in the end so you don't have to worry about pointing the end into the toilet if you like. I use a mentor catheter (bullet end with 3 holes) and I have a medena as back up if I have trouble getting it in (a medena is a stiffer catheter) for whatever reason. I will get my catheter in, I know that and I never panic about that....anymore. At first, years and years ago I was alittle nervous about that since I live 6 hours away from the Mayo Clinic were I had my Kock Pouch performed. The amount of time it takes to empty your pouch depends on your chewing (chew, chew, chew and drink, drink, drink) and fluids, especially thinning fluids....which are coffee, grape juice, prune juice, etc.. Magnesium supplements are also a good one, 400 mg. are the requirements for a day. So I split mine in half. Half in the morning and the other half at night. My stoma is on my right side approximately 4 to 5 inches down from the waist line or belly button. The site of my Brooke Ileostomy was used. I just use a washable nursing pad to cover my stoma to collect the mucous usually after I empty my pouch is when I notice this the most. No poop, just mucous. Also, remember that your gas will be contained in your pouch also. At first, your gas will be alot more, but as time goes on it will get better. You will learn what foods bring on gas, etc. for you personally. I don't drink carbonated beverages, I don't smoke, I don't drink alcohol and I don't use a straw, these are gas producers. You change the covering over your stoma when you empty your pouch or more if needed. I have found that gas-x does work for me....if I want something that causes gas for me...like beans. Or you just have to take into consideration that you will have to empty your pouch more. I empty my pouch usually 3 times a day and sleep all night. It is nothing to insert a catheter into your stoma....no big deal, it is second nature to us Kock Pouchers. I use olive oil for lubricant for my catheter and sometimes just water. In the beginning, I used KY jelly. I think you will like a Kock Pouch, no more emergency runs to the bathroom, no more rectal stump inflammation issues. It's really great Eric...I wish you the best and I can't wait to hear how your appointment goes. I love my Kock Pouch....just love it!!!!

I've done a lot of research and decided to go for the BCIR. I emailed with at least five people, including vanessavy, and every one of them were very positive about it. I also made a point to talk to folks in the same position I am: jpouch and tired of fighting chronic pouchitis. Everyone said that quality of life is astronomical compared to jpouch.

I'm scheduled for the surgery next week. I'm really looking forward to not being held hostage to pouchitis.

YAY! THE BCIR is the best kept secret I read to may negatives about the kpouch so went with the BCIR too. But a pouch is a pouch. I am on a new antibiotic for pouchitis but just really have gas so now on Bentlyn and that drug knows the gas around or gets rid of it asap. SOOOO happy I got that today from my surgeon's office. Just have to have patience it is a big time surgery. Maybe not as bad for you since you don't have a colon anymore. I had a lot removed so slowly getting there.
I sleep through the night 1am -10pm is my schedule lately and s ince I am contnent I don't have to use the bathroom right after I eat. RIght now I can go 6-6.5 hours without drainin. Schedule next week to hopefully be a little over the 6.5 until I reach 12 hour holds.

I agree and I've been thinking about that. You had everything removed and had a new "plumbing system" configured all at once. That would be a tough gig. I think it's great that you can already go 6.5 hours before emptying!

I'm sending you another PM. I have yet another question. Thanks!

Thank you guys!!!!! That's exactly what I'm looking for, leaning more towards the BCIR, I'll is cuss it with Dr Cohen when I see him in four weeks and see what he thinks, thanks again, I'll keep everyone posted!!

Big hugs!
Eric

Eric,
Dr Cohen also does a living collar, the same as the BCIR..A mild variation on the K pouch...he did one on me so that there is really no difference between them.
You can ask him.
Sharon

I did a lot of research the past few month because I am having surgery next week to get a k-pouch. From what I could tell, both the k-pouch and BCIR are essentially the same these days. Initially the k-pouch had a lot of problems that Dr. Barnett addressed when he created the BCIR, but the k-pouch has since been modified with essentially the same modification - it think the modification is the nipple valve. I found 2 places that the BCIR is performed, in the LA area and in Florida. The k-pouch is done by a few surgeons around the country. I have a drawing I can send later if you are interested. (I tried to attach it but it's in the wrong format.) I hope this helps.

Just a note...the BCIR valve is a living collar valve, and the Kock pouch valve was revised years back using different type of mesh. It is not the same.

In the U.S. for example, the Cleveland Clinic, Scripps in LA and other places only do the Kock Pouch, and the other surgeons do only a BCIR.

But, I assume Dr Cohen in Canada is doing both from what Sharon posted. That is not the norm.