Kock Pouch for UC

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lixxie
Regular Member


Date Joined May 2005
Total Posts : 151
   Posted 8/23/2005 9:36 PM (GMT -6)   
I've had Ulcerative Colitis since I was 12, and well, I've had enough!
 
I'm due to see the surgeon next week to dicuss my options. I'm pretty sure he's going to do the J-Pouch dance and convince me that's what I should do, but I'm still unsure it is for me.
 
I've been reading about the BCIR, and it's sounds very interesting, but I'm in Australia, so with two continents and an ocean between me and the surgeon, that could pose some problems, lol.
 
I've heard a little about the Kock (Koch) Pouch, on which the BCIR is based, but only a little. I'm having trouble finding much info about it, or finding anyone who has had it done.
 
I want to find out as much as possible about my options before my appointment, so I will know what questions to ask and wont be totally confused.
 
So, has anyone heard of/had a Kock Pouch operation?
 
Ta.
23 yrs old ~ 4g Salofalk p/day ~ seeing the surgeon on 30 August


Suzy2
Regular Member


Date Joined Aug 2003
Total Posts : 335
   Posted 8/24/2005 3:06 PM (GMT -6)   
Hi lixxie.

I have sent you an email with some info. Let me know if you don't recieve it.

Sue


lixxie
Regular Member


Date Joined May 2005
Total Posts : 151
   Posted 8/24/2005 3:40 PM (GMT -6)   
Thanks, I have. And I'll certainly look into it. Thanks again.
23 yrs old ~ 4g Salofalk p/day ~ seeing the surgeon on 30 August


medicine tongue
Regular Member


Date Joined Apr 2005
Total Posts : 49
   Posted 9/2/2005 8:54 PM (GMT -6)   
I have a friend that had the K-pouch surgery about 8 months ago. The recovery for him was extremly fast, i saw him about 2 1/2 months after surgery and could not tell, he looked no different. He is very happy with the surgery and says he can eat almost anything (no pine nuts or things of that nature). The only disadvantage to this surgery and why it is a bit dated to the j-pouch is you need to carry a tube (capiture) with you to stick in a hole around your belly button to empty. He said he empties it 2 times a day but it has gotten caught before and was hard to get out. He also said it is sometimes embarssing when he is in public and has to empty it because he has to wash the tube out every time he uses it and most people give him strange looks. From the people i know that had Jpouch seem to be doing very well but it is a longer recovery. The doctor left him the option to change the k-pouch to a j-pouch (left a few inches inside) but sais the longer he waits the harder it will be to reconnect. I personaly would go for the J-pouch but it is a very personal decision and different for everyone.

lixxie
Regular Member


Date Joined May 2005
Total Posts : 151
   Posted 9/2/2005 9:58 PM (GMT -6)   
Thanks Medicine Tongue. Yeah, I'm leaning toward the j-pouch, and if that fails perhaps then investigate converting to a k-pouch. My surgeon doesn't perform k-pouches but knew of a collegue here in Melbourne who does.

BTW, I've been reading a lot about all this, and someone with a k-pouch said that they sometimes put the tube in a zip-lock bag and wash it later. Might be an idea for your friend.
23 yrs old ~ 4g Salofalk p/day ~ saw the surgeon, still deciding


Janene
Regular Member


Date Joined May 2005
Total Posts : 89
   Posted 9/9/2005 9:11 PM (GMT -6)   
Hello Lixxie,

I just wanted to tell you a little about the BCIR. I had my surgery on July 22nd. I am 7 weeks post op and feel absolutely great. I have not felt this good in years. Rinsing off the catheter can get a little embarrassing but you can put it in a bag as stated in the previous post. I try not to do it in public unless absolutely necessary. I had looked into he j-pouch and had my surgery scheduled for it last year. Something told me not to do it so I didn't. I do not like the fact that you still need to go to the bathroom and it still controls you. With my BCIR I go when it is convenient for me. I do not have accidents or leaks. I know a few people who have the j-pouch and they still have flares because the small section of the rectum can still flare with UC. I know 3 that are taking Remicade treatments because of it. I had surgery to stop all of that. A man from my church just got out of the hospital with a flare with the j-pouch. Plus alot of people end up wearing diapers at night so not to have accidents in the bed. No thank you. I had accidents from the UC. I thought having surgery is supposed to solve those problems.
I feel great. I even went to Gatorland last week with my family. I never expected to be out and about this soon after surgery. Yes coming to Florida can be hard but there are patients from all over the world that come here to have it done. It is worth the trip and will change your life for the better. I looked at it as an investment into the future with my kids. I am 29 with 2 kids. They need me healthy and ready to go when they are.
If you have any questions feel free to ask. I have no regrets and happy I can now enjoy life again.
Janene

Cat2005
New Member


Date Joined Jun 2005
Total Posts : 11
   Posted 9/13/2005 6:46 PM (GMT -6)   
I have a BCIR going on 13 years. I drain my internal pouch twice a day (morning and at bed time). Very rarely do I have to deal with a public bathroom. When and if I do, I take one square of tissue and clean the outside of the catheter. I then fold the catheter in the palm of my hand and out to the sink I go. I have found that throughout the years, no one is watching me.

ptrmzr
New Member


Date Joined Sep 2005
Total Posts : 1
   Posted 9/24/2005 11:59 PM (GMT -6)   
Hi, I currently have a j-pouch and may be required to go to a ileostomy bag or other internal/external device. I was intriqued by the Kock Pouch but how does the BCIR differ fro the Kock pouch and where is the procedure performed?
Thanks, Peter

Janene
Regular Member


Date Joined May 2005
Total Posts : 89
   Posted 9/25/2005 9:12 PM (GMT -6)   
The BCIR is a revised version of the Kock pouch. I am not completely familiar with the Kock pouch but have been told that the BCIR is better now that it is revised. But I am not completely sure to the accuracy of that since I do not have a Kock pouch. The BCIR has a valve and also what they call a living collar so there is no leakage .
You can go to www.bcirostomy.com and read about it and email Sue Kay and she can help you and send you a dvd of the pouch and everything. This should answer all your questions.
The BCIR is preformed in St. Petersburg Florida. I live here so it was only a couple hour drive for me. I am so glad I did it and wish I had done it sooner. I am so happy. I even got a job for the first time in 4 years. I a cannot tell you the difference it makes.
Janene

rissy
New Member


Date Joined Nov 2005
Total Posts : 1
   Posted 11/5/2005 12:45 PM (GMT -6)   
Hi everyone,
 
I am 19 years old and was diagnosed with UC when I was 13. I have since had 3 major surgeries, plus a stoma revision. (Jpouch-1, temporary ileostomy-2, and then the removal of my Jpouch-3). I  have had a permament ileostomy since I was 16 and have tried my best to live with it but I emotionally cannot handle it anymore. I am looking into some alternative surgeries including a newly developed T-pouch (only done in California), the BCIR and the Kock pouch. I live in NY and it would be very inconvenient for me to have to take an airplane to get the surgery done. My dad talked to  my colo rectal surgeon a few days ago and he told him that the BCIR was basically the same thing as a Kock pouch. They have made some improvements on it but not enough to warrant going all of the way to Florida to have the procedure done. I was wondering if anyone else needed to make a decision like this and if so, what did they decide to do and how are they feeling now..? I am just at the end of my rope and desperate to do SOMETHING. It took me about a year to convince my parents of the need for me to get rid of the bag, but i think they have finally come around. We are leaning towards the Kock pouch but havent heard the best things about it. Can anyone offer me any advise as to how to go about this process? i would appreciate it...thank you
 
take care

reeza
New Member


Date Joined Nov 2005
Total Posts : 1
   Posted 11/15/2005 4:02 AM (GMT -6)   

We are in Australia too.  My husband has j-pouch but has much trouble with it (including chronic pouchitis). Looking hard at alternative options now and particularly at Kock/BCIR.  We did not think anyone in Australia did Kock/BCIR.   Would very much appreciate Lixxie  if you could let us know by email who it is in Melbourne who does

Looking also around the world.  Unfortunately, American surgery is just too expensive for us without insurance available.  Husband is UK citizen so Europe possibly a better option.  Any info on who specialises in this work around the world (apart from in US). We want it to go right this time...

Also - I gather that pouchitis can be a problem with Kock/BCIR too.  Any difference in likelihood of suffering pouchits as between K and J pouch?? Is pouchitis an expression of the auto-immune dysfunction in that the pouch is being 'rejected'?  If so I guess he might be up for the same problems with the K?

 


lixxie
Regular Member


Date Joined May 2005
Total Posts : 151
   Posted 11/15/2005 4:29 AM (GMT -6)   
Hi Reeza,

Your email is 'unavailable' so I'll just write here what I know, which isn't a whole lot unfortunately. I saw my surgeon (James Keck, he has rooms at St Vincent's here in Melb.) and he's convinced me to give the J-pouch a go. When I met with him, I did ask about K-pouches and he said he thought he knew of another surgeon who still did them, but that they are rare nowadays and problematic ... bla bla (doing the hard sell on the J-pouch!)

So he didn't actually mention the other surgeon by name, I'm sorry. But I guess if you and your hubby are determined, you could perhaps meet with him and get a referral. If you are out of the state, I'm seeing him in a couple of weeks to set a date for surgery and could ask for some names if you like.

My email is lixxie100@hotmail.com if you want to get in touch.

As to the other questions, I do know that pouchitis can be a problem with Kock/BCIRs too. Though I'm not sure about the connection with pouchitis of a J-pouch or the relation to auto-immune dysfunction. I guess that would be a question for the surgeon.

Good luck finding someone, and once again I'll be more than happy to get some names from my surgeon if I can. We all know what a sh**ty disease this is and if I can help, I'd like to.
23 yrs old ~ 4g Salofalk p/day ~ surgery set for April '06


Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1245
   Posted 11/17/2005 6:23 AM (GMT -6)   
Reeza, the Kock's Pouch is available at various hospitals in Australia. Hubby's surgeon should be able to find out info for you.

Just bear in mind that if you travel to the USA for a BCIR and something goes wrong with it down the line and hubby needs treatment for it, no doctor in Australia will touch it - you'll have to travel back to the USA for treatment. That could get very expensive :(

Both the j pouch and the Kock's pouch (and BCIR) utilise the small intestines as an 'internal pouch', therefore if he is getting pouchitis with the j pouch, chances are high that he will probably still get it with the Kock's pouch unfortunately.

Good luck with what you both decide.

http://www.ostomates.org
I'm not a complete idiot - some parts are missing!
________________________________________________

Ileostomy for 27 years since I was 10 years old, due to UC.


Lesrich
New Member


Date Joined Apr 2004
Total Posts : 9
   Posted 11/27/2005 5:21 PM (GMT -6)   
Rissy
I had a Kock pouch for 24 years and we had a great relationship. I did me well and I felt fairly normal. As of October '03 I have an end ileo but am scheduled for a second Kock in January (that's how much I liked it!) There are many people around with successful Kocks..you just don't see them on the boards.
Joel Bauer is a surgeon in NYC at Mt. Sinai hospital that has done quite a few Kocks in his day. I bet you can google his name. Another excellent colo-rectal surgeon for Kocks is Victor Fazio at the Cleveland Clinic in Cleveland.
Good luck. I'll help you if I can.

Ludo
New Member


Date Joined Dec 2005
Total Posts : 1
   Posted 12/28/2005 11:51 AM (GMT -6)   
Hi All,

Very interesting reading this. I got a bad case of UC in argentina (I'm english) and had emergency surgery there in 2002. I've had attempts at a j-pouch and they have been unsuccessful coz of my bladder being fused to my rectal stump (argentinians saved my life but left too much scar tissue around there). I'm now looking at a kock pouch (the other areas of my lower abdoman are fine). Does anyone know if they are still available in the UK? I'm encouraged by the positive stories re K-pouches on here. I'm gonna enquire with surgeons when I'm stronger and fitter after a recent failed j-pouch op.

take care and happy 2006 to everyone on here

petsitter
New Member


Date Joined Oct 2008
Total Posts : 4
   Posted 10/26/2008 9:36 AM (GMT -6)   
My son has a k pouch. His j failed. I have had a j for 20 years. I have a list of surgeons who do the k pouch and BCIR.
Feel free to e mail me,
I am always willing to help.

petsitter
New Member


Date Joined Oct 2008
Total Posts : 4
   Posted 10/26/2008 9:38 AM (GMT -6)   
There are not any drs currently in Australia doing k pouches. Dr Susan Shedda is getting ready to do them in Melbourne.
She was a fellow at CC Ohio.

annyb
Regular Member


Date Joined Feb 2009
Total Posts : 62
   Posted 3/7/2009 11:34 PM (GMT -6)   
I am so glad that I was told about the HW boards. I have learned sooooo much. I have CD and was told that I needed a permanent ileo. But now I am finding K pouches and BCIR pouches. That is two more options that I can ask about. (I'm not a candidate for a J pouches as some of the CD is in my rectum.)

Everyone keep your fingers crossed for me. I'm headed to the CC in April to meet with some specialists.

-K
Crohn's Disease - 29 years
Diagnosed at age 10 in 1979
1st ileosecal resection 1989
2nd colon resection 1993
Chronic "D" and arthritis
Chronic rectal stricture with colonoscopy every 3 months to dialate
Insomnia since 1980 - I love my ambien!
 
SCUBA diver, Master's degree student, college graduate, Pet therapist
 


Cors
New Member


Date Joined Sep 2007
Total Posts : 2
   Posted 1/24/2010 9:02 PM (GMT -6)   
Hi Reeza,
I know this was in 2005 just want to let you know I have now had the K-pouch in Melbourne in 2009 under Prof Mackay from St Vincents and Head of Epworth Eastern Hospital Melbourne Australia.  I put some info in the "Ostomy Section".  I had the permanent ileostomy and Prof Mackay brought Prof Fazio out from the States and they performed the operation on me last year.  It was very tough surgery though I would so prefer this to the ilestomy.  It was covered on medicare and through MBF.  He is an amazing surgeon and I would certainly recommend him.  Prof J Mackay, Epworth Eastern Hospital Boxhill Melbourne Australia and or St Vincents Hospital.
Hope things are alot better (if you want to know further I am happy to be incontact by email
Kind regards
Cors

Kock Pouch 1974
New Member


Date Joined Aug 2010
Total Posts : 1
   Posted 8/22/2010 8:23 PM (GMT -6)   
Better late then never...I had the 31st Kock Pouch in the US back in 1974. Works as well today as the the day it was done. Don't give up hope!

andorable
Veteran Member


Date Joined Jun 2005
Total Posts : 981
   Posted 8/24/2010 6:10 AM (GMT -6)   
I heard about the Kock Pouch not that long ago too in my ostomy magazine that I get every couple of months. I too am in Australia in Queensland and was so interested I emailed my surgeon in regards to it and he said there was only the one surgeon in Australia ( Melbourne) Who does this surgery as most have abandoned this surgery due to lots of ongoing problems and according to him it required more than one surgery. Anyway he did tell me he would be happy to keep me posted if there were any new developments with it. I also agree with Shaz that if you were to go to the USA to get this done no doc here would touch you if you were to have probs with it. Thanks for answering all the questions I had in regards to this surgery as well everyone it was interesting reading, and for those of you that are fortunate enough to have had no problems with this surgery I am very happy for you. Take care all

indialogue
New Member


Date Joined Mar 2014
Total Posts : 9
   Posted 3/18/2014 6:10 PM (GMT -6)   
Sorry to hear so many people having pouchitis problems. I was diagnsosed with UC when I was about 16 (I'm now 63). The only period of remission I had was an eight year period in my 20s when I smoked marijuana. It worked wonders! I stopped using it when I decided to return to college to get my Ph.D. The UC immediately returned in grad school, and I eventually had a complete colectomy and a Koch Pouch (the predecessor to the J Pouch). I had my option for either one, but chose the Koch Pouch. Because of the construction, I'm able to irrigate the pouch each time, which I think keeps things pretty clean. In the 26 years I've had the pouch, it has worked amazingly well about 90% of the time. I have had short periods of pouchitis occasionally which have been well-controlled with Cipro and probiotics. I exercise regularly with a trainer at the gym and have learned that any "crunching" exercise (e.g., sit-ups) will activate the pouchitis. Thus, I have to be careful. Hopefully, you all will find an answer. I think it's probably different for each person. When I retire (in less than a year), I fully plan to use medical marijuana. I suggest people give it a shot. I found a great colorectal surgeon here in Washington that is an expert in pouches.
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