First things first, allow me to explain the surgery that I have had.
If you have read my previous posts, you are welcome to skip a little further down, if you are new to this space – this information is for you 🙂
The Surgery, Risks & Benefits
An IRA or an Ileorectal Anastomosis is quite a rare surgery for people living with IBD or other conditions such as my own. It requires a total colectomy where the small bowel (ileum) is then connected to the rectum. This is to enable ‘normal’ bowel functions whilst removing the problem organ (the colon). There are both benefits and risks with this surgery depending how you wish to look at it. There is obviously the benefit of still being able to use your bowels ‘normally’, whilst there is a risk of incontinence and rapid urges to go to the bathroom, bowel obstructions due to scar tissue and the continued use of your bowels, an increase in number of times you require the toilet, dehydration – this; however, is for all people without a colon; though the main risk is the time immediately following surgery where there is uncertainty whether the small bowel will seal with the rectum in order for it to function. Though there are obviously ‘risks’ in the surgery, the benefits, personally far outweigh all of the risks.
The reason I was able to have this surgery, rather than an ileostomy bag came down to personal choice. For some people with Chrons and UC this option is not available due to bigger complications such as their rectum and its functioning. I was given the choice of taking the risk and having the Total Colectomy with IRA or jumping straight to an ileostomy bag and not removing my colon. Personally, it came down to the possibility of having the opportunity to live without a bag. To be honest, I had come to terms with the fact I was going to need one, but when they gave me this option it seemed worth the risks to give it a red hot go! Boy am I happy I did.
Here is a photo of what is happening inside following a Total Colectomy with IRA.
What is it like living with an IRA?
Living with an IRA has its complications 110%; however, I have been quite lucky in how my body has responded. That is by no means to say that what has happened to me will occur to everyone. But here is the nitty gritty of all things bowels following surgery..
- I use my bowels about 4/5 times a day.
- Due to my condition, my bowels are relatively normal; however, some days I have trouble determining when I will need the toilet due the rapid urges that come on in seconds.
- I have become quite good at walking into an unknown environment and clocking where the toilet is ‘just incase’.
- I have only had 1 ‘incontinence’ accident which was extremely strange, thankfully I was at home. If this is a regular occurrence for you I highly recommend increasing your fibre intake and if it continues to return to your surgeon.
- I often get rapid urges to go to the toilet where I find myself holding on for the toilet; though, I have had no issue in getting to the toilet in time.
- My diet has done a complete 180 from what I ate prior to surgery, you can read all about that here.
The recovery has been challenging and I have experienced both good and bad days. I find myself to be quite a positive person and personally believe this is the reason I have found the surgery relatively smooth overall. I have had some significant pains around my scar area which my doctor highlighted was likely scar tissue, but overall the pain has been bearable. I have managed to go for a small walk most days which has been amazing for my headspace and I highly recommend for anyone that is embarking on this recovery. It is by no means easy, figuring out what foods work with your bowel is key; though is also quite a lengthy process, figuring out what you can and can not do to begin with is also difficult but in time you will find that everything falls into place.
If you would like to read more about my recovery you can read my previous recovery updates with some photos of my scar too 🙂
If you have any questions please feel free to comment below and I am happy to help.
Thanks for reading!