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General

Our program is made up of a core team of health care providers who have been identified as BCIR staff. A team philosophy is at the core of this program and these dedicated professionals are experienced in taking care of patients with this advanced surgical technology.

Candidates

Hal, 1 week after J-pouch removal and creation of a BCIR.

Indications for the Continent Intestinal Reservoir are:

  • Patients who have problems associated with the conventional (Brooke) ileostomy.
  • Patients who have failed continent (Kock) pouch, failed Ileal Pouch Anal Anastomosis (IPAA), J-Pouch, Pull-through or other similar procedures.
  • Individuals who have Familial Polyposis (FP), a case of medically unresponsive Ulcerative Colitis, poor anal sphincter control or other conditions precluding their being candidates for the J-Pouch, or those who elect not to have the J-Pouch.

The best way to learn whether you are a suitable candidate is to contact our staff and to gather your past medical history. The following forms may be helpful in that endeavor; we recommend that you give a completed form to each of your previous medical providers.

Procedure

Construction of the BCIR involves taking down a pre-existing ileostomy or removing the colon and rectum if this has not been previously done. The pouch itself is formed from about two feet of the patient's intestine. The valve and collar are also made of intestinal tissue.

When a sensation of fullness occurs, the pouch is drained by inserting a catheter through a button hole-shaped opening (stoma) located just above the pubic area. This is usually done two to five times daily. There is no projecting spout such as you would have with a conventional ileostomy. The opening is covered with a small adhesive dressing.

Recovery

Christine recovers in her room after surgery.

Due to the distance traveled by most of our patients and the technical aspect of the procedure, the hospital stay varies but usually is from 18-21 days. This time period allows for the suture lines in the pouch to heal and for you to begin the process of draining (called intubation) your BCIR. By the time you are ready for discharge, you will be able to fly or drive home. Hyperalimentation, antibiotics and pain medication will be a part of the post-op care as well.

Dr. Ernest Rehnke describes the recovery process

After Care

For the first several weeks after surgery, you be asked to call and provide weekly progress reports. Once you have fully recovered and feel comfortable with your BCIR, after-care will vary by patient. We do, however, hope to maintain a long-term relationship with you by your participation on our chat room, Facebook, Twitter and annual follow-up questionnaires. We also do hope that you participate in our annual educational symposiums that are sponsored by the QLA.