Question:

Our daughter currently has a cecostomy, which has not been effective. We’ve been advised to consider a total colectomy with end ileostomy or an ileorectal anastomosis, but she is hesitant—especially about having a bag. We’ve heard about the K-pouch as an alternative. Is this procedure still performed in Canada, especially for minors?

Answer:

I’m sorry to hear that your daughter’s cecostomy hasn’t been effective. Facing such a major surgical decision is understandably difficult, and it’s important to weigh all options carefully with the best available information.

Here are a few key considerations and next steps:

1. Get Guidance from a NSWOC

Before moving forward with a decision, connecting with a Nurse Specialized in Wound, Ostomy and Continence (NSWOC) can be incredibly helpful. These nurses are trained to provide education and emotional support and can walk your daughter through what life could look like with an end ileostomy, helping to address concerns or fears about living with a bag. You can find an NSWOC near you through this link:
Find a NSWOC – Ostomy Canada Society

2. Understanding the K-Pouch Option

The Kock pouch (or K-pouch), a type of continent ileostomy, is a less common surgical option today. Fewer surgeons perform this procedure, and it may not be appropriate depending on your daughter’s medical history. There is also limited availability of pediatric surgeons in Canada who specialize in this approach.

However, you can reach out to Mandy Rickard at SickKids Hospital, who may be able to provide more detailed information specific to your daughter’s situation.
Contact: [email protected]

Answered by

Kathy Rego, RN, NSWOC
Nurse Specialized in Wound, Ostomy and Continence