Over the years, surveys of patients reveal that about 90% of people with a Barnett pouch (the BCIR is the Barnett modification of the Kock Pouch - the Barnett Continent Intestinal Reservoir) eat anything they want without limitations. Some food with roughage (mainly cellulose fiber in fruits and vegetables) does not break down very well, and it takes longer to evacuate because the drainage catheter gets plugged up and must be removed, cleaned, and re-inserted to finish emptying the pouch. Compared to a conventional Brooke ileostomy, nutrition is enhanced because nutrients are absorbed in-between intubations (self-catheterization), instead of the food material passing into the external pouch appliance where it can't be absorbed. The BCIR pouch is made from your intestine and continues to function like intestine should.
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The need to cure a disease or condition by removing the entire colon (large intestine) and rectum requires creating a way to evacuate the intestinal waste. The three options available include the conventional Brooke ileostomy, the ileoanal J-pouch, or the continent ileostomy.
Conventional Brooke ileostomy surgery requires a permanent external appliance to collect the intestinal waste because the small intestine is a continuous flow system. Material is produced continuously, even when not eating. The end of the small intestine is brought through an opening in the abdominal wall and sewn to the skin to form a spout or nipple-like projection. This allows the waste to flow into the appliance without contact with the skin. The waste from the small intestine is corrosive to skin, so the appliance must be cemented onto the skin and worn at all times. While most people with a Brooke ileostomy lead a normal life, a significant number will have episodes of leakage with skin irritation, allergies to the adhesives, problems with "bag bulge", limitation in activities, and difficulty making the emotional adjustment to life with an appliance especially regarding intimate relations and dating. In fact, 11% of people with a Brooke ileostomy will require a surgical revision during their lifetime. This may be for retraction of the stoma with inability to maintain a seal, prolapse (a stoma that becomes very long and rubs against the bag), or hernia.
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