I meet with my surgeon today to discuss my options (I had UC which led to a colectomy and ileostomy in August). I'm trying to prepare with some questions to ask. Any thoughts? I an scared to go into yet another surgery - my first one was very hard, but I was also very sick going into it.
Is it possible he will do this surgery in Two steps? Are there questions I should definitely ask before making my decision about whether or not to have a jpouch created, or if I should just make this ileosotmy permanent? I think I really want to try the jpouch, I'm 32, and now that the big bad colon is gone I am much healthier. I'd love to be bagless, if possible. After my surgery they decided my Colitis was indeterminate, so my GI has warned me that I could have actually have Crohn's, so I could be more susceptable to pouchitis. Sot here's that to consider, too.
Ugh...any advice> Any good questions I should ask?

Depending on your surgeon, it is likely that the j-pouch will be in 2 steps. But, if you get very healthy in the meantime, it is very possible to have only one more step and avoid the loop ileostomy, which is much more difficult to manage than the end ileostomy.

Indeterminate colitis does put you at a higher risk for chronic pouchitis or Crohn's disease of the pouch, but that is not necessarily a reason to not try the pouch. It all depends on what you consider an acceptable risk. You cannot have your rectum removed and opt for a permanent stoma and later change your mind and try the j-pouch. However, the opposite is true. You can revert to an end ileostomy if you find that the j-pouch does not work out for you.

Another option to consider is the continent ileostomy (Kock pouch or BCIR), but it is not without potential complications either. Basically, there is no one, perfect solution. There is nothing wrong with choosing an ileostomy, but don't make that choice out of unreasonable fear.

Ask your surgeon how many j-pouches he has done and how many of them have been with an indeterminate diagnosis. Also ask about the rate of various complications with his patients. Ask if he has a list of patients of his you can call to discuss their experiences.

Jan