Ileostomy diet vs. BCIR diet

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lasbutterfly
Regular Member


Date Joined Nov 2007
Total Posts : 281
   Posted 1/30/2010 8:02 PM (GMT -6)   
The Ileostomy Diet

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.


suebear
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Date Joined Feb 2006
Total Posts : 5690
   Posted 1/31/2010 4:13 PM (GMT -6)   
I know many people with kpouches who continue to have blockage problems and certainly don't eat what they want!
 
Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


lasbutterfly
Regular Member


Date Joined Nov 2007
Total Posts : 281
   Posted 1/31/2010 4:19 PM (GMT -6)   
Sue, I only posted this article for people as a reference. I have been researching the good and bad of BCIR vs. Ileostomies. BCIR is a revised K-pouch. I do not have either, but am considering BCIR if my doctor at Cleveland Clinic ok's it in March.

butterfly

Shaz032
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Date Joined Feb 2003
Total Posts : 1243
   Posted 2/1/2010 5:27 AM (GMT -6)   
Be aware that you also have to be careful that you chew things into mush otherwise it won't fit through the catheter, I know people with Kock's pouches and BCIRs who can't eat nuts, peas etc they have tried but just can't chew them into pieces small enough to fit through the catheter and hence "A trip to the emergency room is often needed to flush out the stoma and dislodge the obstruction".

I'd say this is advertising blurb for the BCIR? It may be true for the majority of BCIRers, but then again, most of it would be true for the majority of ileostomates too (I can eat whatever I want without a problem with my ileo - I don't take nutritional supplements either and I've never been deyhydrated in my ileo's 34 year history). It's just the BCIR people trying to talk up and sell their surgery (it's a patented op only done at a few hospitals).

If you do go the BCIR route, be aware that if something does go wrong down the track (the most common thing is nipple valve slippage) you will have to travel back to where you originally had the surgery as no local doctors will touch it since it's such a specialised surgery. The Kock's Pouch is, however, more commonly done.

Good luck with your decision.
Ileostomy for 33 years due to UC

Moderator of the Ostomy and Psoriasis Forums

_______________________________________________

I'm not a complete idiot - some parts of me are missing!


Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1243
   Posted 2/2/2010 6:48 AM (GMT -6)   
PS (taken from another website, post written by an ET) It is important to appreciate that all essential nutritional uptake absorption of foods and oral medicines takes place within the intact small bowel; therefore, most "normal" ileostomates and colostomates will have likely absorbed all the nutrition and medicines their body needs before stool exits the stoma.
Ileostomy for 33 years due to UC

Moderator of the Ostomy and Psoriasis Forums

_______________________________________________

I'm not a complete idiot - some parts of me are missing!


honestwoman50
Veteran Member


Date Joined May 2009
Total Posts : 833
   Posted 2/3/2010 3:07 PM (GMT -6)   
Just wondering ???  Does the doc decide what kind of ostomy, k pouch etc that you get or do you get to decide on your own what you want...  I see the surgeon tomorrow morning am I am trying to get as prepared as I can for the consultation.
 
The one where you dont have to wear a bag sounds nice, not to have to wear one but I guess you irrigate to get stuff out....  Maybe I have been reading far too much because I am getting confused as to what each of them do and there are so many different ways to go...can anyone help?  thank you for reading I do appreciate all the input everyone has given me.
 
You know this web-site has really been a blessing for me...Leslie
Leslie King


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5690
   Posted 2/3/2010 3:10 PM (GMT -6)   
It's a combination of both. The patient decides what surgery he/she wants but not all surgeries work for everyone's condition. Generally a jpouch or kpouch is not good for a diagnosis of Crohn's but it does work for people with UC. It's really up to the patient to research and know what their options are before seeing a surgeon.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


honestwoman50
Veteran Member


Date Joined May 2009
Total Posts : 833
   Posted 2/3/2010 3:12 PM (GMT -6)   
Sue, I have a pelvic floor disorder, my anal sphincter muscles are clamped down on the outer and the inner one does not work well , also nerve damage
Leslie King


lasbutterfly
Regular Member


Date Joined Nov 2007
Total Posts : 281
   Posted 2/3/2010 4:35 PM (GMT -6)   
honestwoman50, I am waiting to see if I qualify for the BCIR surgery. If you are interested in reading about it, there is a very good site at www.bcir.com and if you send your medical records to Susan K there, the doctor will make a decision as to whether you would be a good candidate or not. This site has pictures, testemonials, a slideshow, chat room, and forum. It is full of information. With the BCIR surgery, you would not have an external appliance. You would have an internal pouch made out of a portion of your small intestine.

butterfly

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5690
   Posted 2/3/2010 4:59 PM (GMT -6)   
Leslie,

Yes, you would probably be an ideal candidate for a k or BCIR. The k is more widely practiced making aftercare or emergencies easier to deal with. Essentially they are the same surgery only the BCIR has a proprietary valve.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1321
   Posted 2/3/2010 6:00 PM (GMT -6)   
So, is the k-pouch supposed to be better than the bcir? What exactly is the difference in the valves because they both must have valves, right? I HMMMM, wonder if there are any studies comparing the 2?

lasbutterfly
Regular Member


Date Joined Nov 2007
Total Posts : 281
   Posted 2/3/2010 6:37 PM (GMT -6)   
answers4meTDR, I don't know if one surgery is better than the other.  I know that the BCIR is a revised K-pouch.  It was revised, because of valve slippage with the K-pouch.  The K-pouch is performed in many more facilities than the BCIR; however, I live in Florida and am close to a major BCIR facility and doctor in St. Petersburg.  Due to this, I am hoping to be a candidate for the BCIR procedure. confused There is also a major BCIR facility in Los Angeles.
 
butterfly

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5690
   Posted 2/3/2010 9:10 PM (GMT -6)   

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.

 

Sue  


dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


honestwoman50
Veteran Member


Date Joined May 2009
Total Posts : 833
   Posted 2/4/2010 12:39 AM (GMT -6)   
lasbutterfly
and suebear, thank for the info and I will check it out.  Got on to late tonight so will have to do it in the morning...bless you.
Leslie King

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