Significant differences exist between the conventional Brooke ileostomy with external appliance and the BCIR continent ileostomy with regard to diet. In the conventional Brooke ileostomy with external appliance, the intestinal waste is moved through the system and up through the abdominal wall and finally out into the appliance by the muscular activity of the intestine (peristalsis). Fibrous foods and foods that are difficult to digest include raw fruits and vegetables, the skin of a baked potato, nuts, popcorn, mushrooms, olives, and others. These foods can cause a “food blockage” – the flow of waste abruptly stops, and the person gets bloated, with nausea and vomiting occurring soon after. A trip to the emergency room is often needed to flush out the stoma and dislodge the obstruction.
In contrast, with the BCIR these difficult to digest foods move through the system and into the internal pouch. There they will continue to be digested as the pouch is made from the intestine itself. If the food material doesn’t come out with the first insertion of the drainage tube (the intubation or draining process), it will continue to soften up and be evacuated later. Almost all people with a BCIR report that they eat anything and everything that they want.
Also, with the conventional ileostomy, once material passes into the appliance, it can no longer be digested or absorbed to become nutrition. Even the liquid content is lost, and it is well known that people with an ileostomy have a tendency to become dehydrated. In contrast, with the BCIR nutrients and water continue to be absorbed into the body in-between intubations, so there will be much less likelihood of dehydration and the person’s nutritional status is enhanced overall.
Nutritional supplements are not required in general with the BCIR.
I don't know if there are studies comparing the two surgeries but when you look at how widely practiced the k pouch (many hospitals) is and compare that to how few hospitals (2) are doing the BCIR I think unless you lived close to one of those two BCIR hospitals that a k pouch might be a better option. At least that would be my opinion. When I researched the BCIR surgery 10 years ago there were only 2 hospitals practicing that style of surgery then. Not much has changed in 10 years.