I have actually never heard of surgeons not being able to do an ileostomy. You'd think it would be the other way around - that the surgeons couldn't do a pouch. My only guess is that perhaps the surgeon constructed the pouch, but there was not enough ileum to do a proper loop (perhaps it was too high up, which would result in short bowel syndrome). Either that, or if there have been multiple previous surgeries, there may have been excess scar tissue which prevented a proper exit for the stoma.

Regardless, it does sound somewhat unusual. I would be curious to find out the reasoning.

As for one steps in general, though, while still not as common as the 2 step, these are being done all the time. There are varying opinions as to the pros and cons, and since I'm not an expert on that, I won't weigh in on it--though of course, one obvious benefit of a one step is not having to bother with the temporary ileo. I will also say that my own surgeon says he would not do a one step, simply because he feels strongly that the pouch must be given a good 3-6 months to heal. But as I said, many people on this forum have done one steps are are doing just fine.

The "nose tube" is mostly likely an NG tube. Very common after surgery. It's used to drain the stomach in order to allow the bowel complete rest.

Thanks spooky

I asked my friend about the ileostomy again. He said it wouldn't stick. I guess that means there wasn't enough bowel?

I remember my loop was very flush to begin with

I had my initial colectomy and ileostomy in May of 2012. In November of 2013my surgeon took down my ileostomy and formed a j-pouch all in one surgery. I too had a tube in my nose (NG) for 10 days until my bowel decided to wake up and start functioning. Since then it has been smooth sailing. The surgeon did not know if he would be able to do it all in one step but he worked his magic and I love him for it.

A one-step procedure has plenty of advantages, though most surgeons seem to get slightly better outcomes from a stepwise approach. I *chose* to do the whole thing in a single step (one quick operation, one miserable hospital stay), and I'm glad I did. I was able to get back to work about six weeks later, and I was done with it.