Diving with a J-pouch

Frog Princess · 11th October 2006, 04:56

Hi
In Feb this year I had my colon removed and an ileostomy formed due to Ulcerative Colitis. I have resumed diving and so far have built my depth back up to about 50 mtrs with no problems.
I am due to have J-pouch surgery and wondered if there were any divers out there who have had this surgery.
I have managed to find 3 divers so far who have had it done. One is fine, one has problems on deeper dives and one doesnt dive deep.
Not much to base my decision on really.
As there is no official research available any information would be much appreciated.
Julie

apitkin · 11th October 2006, 21:44

Difficult question to answer. It's certainly not in any of the diving medicine textbooks (that I own, anyway).

What sort of problems did the person have?

It may be a very individual thing, depending on the exact anatomy of the pouch construction. So you may well not know if you will have problems until you dive yourself after you've had the procedure.

Andy

Frog Princess · 12th October 2006, 07:07

Hi Andy
thanks for your reply.
the diver having problems was fine until he started going deeper. on deeper dives he got pain on ascent which lasted 24 hours. he has been advised that this could be due to trapped wind expanding on ascent and to slow his ascent down. he is an o/c diver.
as i dive a rebreather i tend to do a slow ascent anyway so maybe wont have this problem.
all the surgeons have said i shouldnt have any problems but i think it would be nice to here it from the horses mouth so to speak. trouble is there doesnt seem to be many people diving with an ileostomy never mind a j-pouch.
i have actually wondered if mine is the deepest diving ileostomy

regards
Julie

babar · 12th October 2006, 07:59

we've dove (dived for you brits) plenty of people with colostomys or iliostomys in the chamber, they do sometimes require venting, but otherwise they do fine. Of course tese are fairly shallow, dry, chamber dives. One option might be rigging a bag with a small vent in it, and an absorbent dressing over that. Of course this would only work in a dry suit senario

abowie · 12th October 2006, 09:13

The point of the J pouch is to return you to as near to "normal" plumbing as possible.

I can't see any particular reason why diving should be a problem once you've recovered from the surgery and everything is working as intended. I guess it'll depend a bit on what the output state of your ileal content is like but if you're diving OK now with an end ileostomy then that ought not change that much. I suspect that you're probably right; you are likely the deepest "colon free" diver out there.

Apitkin's comments ring true to me too. The actual anatomy of these sort of reconstructions is so variable that there would be a wide range of inter-individual variability in outcome. So describing what is "normal" for someone with a J pouch is pretty hard anyway.

Best of luck with your surgery; UC is a curse. Along with schizophrenia, diabetes and rheumatoid arthritis, inflammatory bowel disease has been on my "hope I never get that" list since I was a med student.

Frog Princess · 12th October 2006, 23:16

Andrew and Babar
thanks for your replies.
Babar
I already dive very successfully with the ileostomy and only had one very minor leak when my output was very watery and the pressure forced a small amount round the velcro closure on the bag. I usually put a sachet in the bag to thicken up the output so it doesnt happen again.
Andrew
I wouldnt wish UC on anyone. I had never even heard of it before I got it and it wiped the floor with me very quickly. Its not only the illness thats a problem but after having high dose steroids my joints are full of arthritis and my legs are very weak. I struggle climbing dive ladders sometimes but theres usually someone to help haul me back onboard so I manage. Also riding my horse hurts my knees and ankles.
I have been in two minds about having the j-pouch surgery as Ive only just got back into my diving and I would have to put it all on hold again for quite a long time which is a very difficult thing to do.
Im still waiting for my surgery date. I told the surgeon I wouldnt have it done over summer so if he doesnt hurry up and get me in I will be waiting till next winter.
I cope fine with the ileostomy and it gives me no problems and doesnt stop me doing anything I want to do which makes the decision even harder.
While I wait for my date I will keep pushing myself deeper every chance I get.
Regards
Julie

Sutty · 12th October 2006, 23:24

Quote: (Originally Posted by Frog Princess)

I cope fine with the ileostomy and it gives me no problems and doesnt stop me doing anything I want to do which makes the decision even harder.
While I wait for my date I will keep pushing myself deeper every chance I get.
Regards
Julie

From the point of view of an anaesthetist, if it gives you no problems and doesn't stop you doing anything then why would you want the surgery? Its a big operation which "uses up" a fair bit of your small bowel. Whatever you decide I hope you can dive without problem, the only problem I can foresee is gas within the pouch - may be worth considering your diet before dive days.

Regards,
Neil

Frog Princess · 13th October 2006, 07:46

Hi Neil
There is really only one reason for having the j-pouch and that is for cosmetic reasons....but its a big reason!
There are many negatives and they all keep rolling round in my head.
However as someone said to me I havent had the ileostomy very long (7 months). Maybe after a few years I will be sick of changing the bag, etc. Who knows.
Its a very difficult decision but the surgeon has said Im a very good candidate for it.
Sometimes I wish I didnt have the choice but I guess I should consider myself lucky that I have.
Regards
Julie

roger beer · 24th October 2006, 19:40

Hi there
I've dived with both an end ileostomy and a pouch. Couldnt get on with the pouch what with pouchitis, abcesses, inability to empty the blasted thing without using a large catheter-went back to an ileostomy and have never looked back-I feel well now and the only problem with diving is to empty the bag during a long day onthe boat between dives and having the clip slip off-very unpleasant! so now double clip it I have used both wet and dry suits without problem but do use a shield with a wet suit. Basically having a pouch can turn a nuisance thing into chronic illhealth AND I'm a doctor so no benefit there. I am in the minority I guess but think carefully
Roger

Frog Princess · 25th October 2006, 19:43

Hi Roger
Thanks for your reply.
I have had no problems diving with my end ileostomy so far and that is why its been such a difficult decision whether to have the pouch or not.
Im actually booked in for surgery on 5th Nov and think I have decided to go ahead with it as I think I would always be wondering if I didnt give it a try.
Its another massive chunk out of my life and means me stopping diving again but I suppose it will be worth it if it goes right. If it doesnt I know I will regret it and wish I hadnt bothered.
Im sorry it didnt work out for you. Can I ask if you had Crohns or Colitis? Mine is Colitis.
Have you tried the bags with the velcro closures? I use Coloplast bags and have never had a problem whilst diving. Never liked the look of the clips!
Regards
Julie

11th October 2006, 04:56	#1 (permalink)
Frog Princess New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Oct 2006 Location: Yorkshire Posts: 20	Diving with a J-pouch Hi In Feb this year I had my colon removed and an ileostomy formed due to Ulcerative Colitis. I have resumed diving and so far have built my depth back up to about 50 mtrs with no problems. I am due to have J-pouch surgery and wondered if there were any divers out there who have had this surgery. I have managed to find 3 divers so far who have had it done. One is fine, one has problems on deeper dives and one doesnt dive deep. Not much to base my decision on really. As there is no official research available any information would be much appreciated. Julie
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11th October 2006, 21:44	#2 (permalink)
apitkin New Member Current Rebreather/s: Prism Topaz Other Rebreather/s: Join Date: Feb 2005 Location: Cloud Cuckoo Land Posts: 102	Re: Diving with a J-pouch Difficult question to answer. It's certainly not in any of the diving medicine textbooks (that I own, anyway). What sort of problems did the person have? It may be a very individual thing, depending on the exact anatomy of the pouch construction. So you may well not know if you will have problems until you dive yourself after you've had the procedure. Andy
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12th October 2006, 07:07	#3 (permalink)
Frog Princess New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Oct 2006 Location: Yorkshire Posts: 20	Re: Diving with a J-pouch Hi Andy thanks for your reply. the diver having problems was fine until he started going deeper. on deeper dives he got pain on ascent which lasted 24 hours. he has been advised that this could be due to trapped wind expanding on ascent and to slow his ascent down. he is an o/c diver. as i dive a rebreather i tend to do a slow ascent anyway so maybe wont have this problem. all the surgeons have said i shouldnt have any problems but i think it would be nice to here it from the horses mouth so to speak. trouble is there doesnt seem to be many people diving with an ileostomy never mind a j-pouch. i have actually wondered if mine is the deepest diving ileostomy regards Julie
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12th October 2006, 07:59	#4 (permalink)
babar Curmudgeon Current Rebreather/s: Evolution Sport Kiss Other CCR Other Rebreather/s: Inspiration Classic Inspiration Vision Evolution Other CCR Join Date: Apr 2005 Location: Southern California Posts: 417	Re: Diving with a J-pouch we've dove (dived for you brits) plenty of people with colostomys or iliostomys in the chamber, they do sometimes require venting, but otherwise they do fine. Of course tese are fairly shallow, dry, chamber dives. One option might be rigging a bag with a small vent in it, and an absorbent dressing over that. Of course this would only work in a dry suit senario __________________ Babar Evolution Plus Sport kiss
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12th October 2006, 09:13	#5 (permalink)
abowie Fighting Girl Current Rebreather/s: Sport Kiss Other Rebreather/s: Join Date: May 2005 Location: Land of Oz Posts: 574	Re: Diving with a J-pouch The point of the J pouch is to return you to as near to "normal" plumbing as possible. I can't see any particular reason why diving should be a problem once you've recovered from the surgery and everything is working as intended. I guess it'll depend a bit on what the output state of your ileal content is like but if you're diving OK now with an end ileostomy then that ought not change that much. I suspect that you're probably right; you are likely the deepest "colon free" diver out there. Apitkin's comments ring true to me too. The actual anatomy of these sort of reconstructions is so variable that there would be a wide range of inter-individual variability in outcome. So describing what is "normal" for someone with a J pouch is pretty hard anyway. Best of luck with your surgery; UC is a curse. Along with schizophrenia, diabetes and rheumatoid arthritis, inflammatory bowel disease has been on my "hope I never get that" list since I was a med student. __________________ Andrew Bowie Rebreather-friendly Buddy Last edited by abowie : 12th October 2006 at 09:17. Reason: spellllllllllllllllllllllllllink
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12th October 2006, 23:16	#6 (permalink)
Frog Princess New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Oct 2006 Location: Yorkshire Posts: 20	Re: Diving with a J-pouch Andrew and Babar thanks for your replies. Babar I already dive very successfully with the ileostomy and only had one very minor leak when my output was very watery and the pressure forced a small amount round the velcro closure on the bag. I usually put a sachet in the bag to thicken up the output so it doesnt happen again. Andrew I wouldnt wish UC on anyone. I had never even heard of it before I got it and it wiped the floor with me very quickly. Its not only the illness thats a problem but after having high dose steroids my joints are full of arthritis and my legs are very weak. I struggle climbing dive ladders sometimes but theres usually someone to help haul me back onboard so I manage. Also riding my horse hurts my knees and ankles. I have been in two minds about having the j-pouch surgery as Ive only just got back into my diving and I would have to put it all on hold again for quite a long time which is a very difficult thing to do. Im still waiting for my surgery date. I told the surgeon I wouldnt have it done over summer so if he doesnt hurry up and get me in I will be waiting till next winter. I cope fine with the ileostomy and it gives me no problems and doesnt stop me doing anything I want to do which makes the decision even harder. While I wait for my date I will keep pushing myself deeper every chance I get. Regards Julie
(Offline)

12th October 2006, 23:24	#7 (permalink)
Sutty Classic Kiss diver Current Rebreather/s: Classic Kiss Other Rebreather/s: Join Date: Jun 2005 Location: Glossop, Derbyshire, UK Posts: 802	Re: Diving with a J-pouch Quote: (Originally Posted by Frog Princess) I cope fine with the ileostomy and it gives me no problems and doesnt stop me doing anything I want to do which makes the decision even harder. While I wait for my date I will keep pushing myself deeper every chance I get. Regards Julie From the point of view of an anaesthetist, if it gives you no problems and doesn't stop you doing anything then why would you want the surgery? Its a big operation which "uses up" a fair bit of your small bowel. Whatever you decide I hope you can dive without problem, the only problem I can foresee is gas within the pouch - may be worth considering your diet before dive days. Regards, Neil __________________ Never forget that life is a finite resource.
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13th October 2006, 07:46	#8 (permalink)
Frog Princess New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Oct 2006 Location: Yorkshire Posts: 20	Re: Diving with a J-pouch Hi Neil There is really only one reason for having the j-pouch and that is for cosmetic reasons....but its a big reason! There are many negatives and they all keep rolling round in my head. However as someone said to me I havent had the ileostomy very long (7 months). Maybe after a few years I will be sick of changing the bag, etc. Who knows. Its a very difficult decision but the surgeon has said Im a very good candidate for it. Sometimes I wish I didnt have the choice but I guess I should consider myself lucky that I have. Regards Julie
(Offline)

24th October 2006, 19:40	#9 (permalink)
roger beer New Member Current Rebreather/s: Not Bought Yet Other Rebreather/s: Not Bought Yet Join Date: Oct 2006 Location: wales Posts: 3	Re: Diving with a J-pouch Hi there I've dived with both an end ileostomy and a pouch. Couldnt get on with the pouch what with pouchitis, abcesses, inability to empty the blasted thing without using a large catheter-went back to an ileostomy and have never looked back-I feel well now and the only problem with diving is to empty the bag during a long day onthe boat between dives and having the clip slip off-very unpleasant! so now double clip it I have used both wet and dry suits without problem but do use a shield with a wet suit. Basically having a pouch can turn a nuisance thing into chronic illhealth AND I'm a doctor so no benefit there. I am in the minority I guess but think carefully Roger
(Offline)

25th October 2006, 19:43	#10 (permalink)
Frog Princess New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Oct 2006 Location: Yorkshire Posts: 20	Re: Diving with a J-pouch Hi Roger Thanks for your reply. I have had no problems diving with my end ileostomy so far and that is why its been such a difficult decision whether to have the pouch or not. Im actually booked in for surgery on 5th Nov and think I have decided to go ahead with it as I think I would always be wondering if I didnt give it a try. Its another massive chunk out of my life and means me stopping diving again but I suppose it will be worth it if it goes right. If it doesnt I know I will regret it and wish I hadnt bothered. Im sorry it didnt work out for you. Can I ask if you had Crohns or Colitis? Mine is Colitis. Have you tried the bags with the velcro closures? I use Coloplast bags and have never had a problem whilst diving. Never liked the look of the clips! Regards Julie
(Offline)

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