What is BCIR or the Barnett Continent Intestinal Reservoir?
The Barnett Continent Intestinal Reservoir or BCIR is an intra-abdominal continent pouch that is surgically constructed from your small intestine.
What the heck does this mean?
The dude that designed or created the idea of the BCIR surgery. We are very thankful for this doctor.
Means you can hold or control your own poop, and that it just doesn’t come out when it wants. You decide when you gotta go!
The whole contraption is made with part of your own living small intestine. So in a way it’s natural; there’s no plastic gadgets or duct tape inside you holding this all together. The BCIR is constructed/ positioned in your abdominal area as well.
Aka “pouch.” Before the BCIR, your poop is stored in your colon, after the BCIR surgery, your poop is stored in the reservoir. However, if you have colitis (like I had), then there isn’t much storing going on in the colon, hence one of the many reasons colitis people may opt to get the BCIR surgery.
Ok, ok, so I got this, but how does this work?
How does it work?
So in a perfect world, you eat, your pizza goes to your stomach – gets broken down to more of a liquid, then moves to your small intestine – where it extracts what little nutrients it can find in that pizza, then moves to your colon – to begin the process of dehydrating the rest of that pizza that can’t be used for anything, and waits there until deployment to the toilet.
With the BCIR (Barnett Continent Intestinal Reservoir), the last step above is removed. The colon is removed, and if you have colitis; that’s where most of your problems lie. So if you remove the colon, what changes? For one, your poop’s consistency changes, meaning it’s now going to be a liquid. Again, if you have colitis, your poop probably already is a liquid. Since the small intestine is still in place, your nutrients are still extracted, but instead of moving on to your colon from here, your poop drains into your BCIR, your internal pouch. Like filling up a water balloon.
Ok, so now I have this pouch made of a small part of my small intestine holding my liquid poop. How does it come out? Well, I’m going to tell you! Here’s the weird part I guess. The BCIR inside you, inside your abdomen, needs an exit strategy. So the design of the surgery has whats called a stoma that serves as door from your internal BCIR to the toilet. The stoma sits in/on your lower abdomen off to the right, but below your waistline. The BCIR or Barnett Continent Intestinal Reservoir is constructed with a collar concept, or a valve, so no poop can come out on its own. Again, everything here is made with your own body parts!
So we have our BCIR pouch inside of me in my lower abdomen holding my liquid poop under restriction of a valve. We also have this stoma deal that is where the poop will exit from. Though the design is the same, the stoma can look different for everybody. In general, it’s about the size of a quarter, looks pink or red (intestines have lots of capillaries at the surface). I’ve seen pictures of stomas that are raised and look deep red, however mine is quite subtle, almost looks like a 1.5 inch fold in my skin, and the stoma is flush to the rest of abdomen and nothing protrudes. I could be wearing tight Speedos and no one would have any idea I have a stoma under those sexy shorts.
Moving on, to get the poop out you need a catheter, a plastic tube, a poop-tube! Catheters are common in the medical world, but it is a fancy word for a plastic tube. The poop-tube will become your buddy that you take everywhere you go. They are generally about a foot long, but are of a soft rubbery plastic, so it can be curled up some. Some people have little bags they use to carry around their catheter, where as I just carry mine in my pocket. You clean it with soap and water, along with washing your hands, so it’s not as gross as you think.
The catheter needs to be lubricated somewhat, either with something similar to KY, or your spit. If you want to carry around KY with you everywhere, then do that, but a little saliva will work fine. So you lube the tip of the catheter, and slowly push and twist it into your stoma and into your pouch. You go slow, for you can feel when the catheter hits the collar inside, and the bump when it passes the collar (valve) and enters into the pouch. And wha-la!! You’re pooping!! The poop will drain out through the catheter by gravity and into the toilet. Just make sure you’re pointing your poop-tube into the bowl! Because your poop is usually in a liquid form (ideally), this is a quick process, and you can get back to your movie in record time. There’s no sitting around reading the paper contemplating a good poop; it’s over pretty quick.
Once the pouch is empty, pull out the catheter, and wash up. You clean the stoma with a few dabs of the toilet paper. Now you’re good to go!
So this is how it works, but I will try to go into more detail in other parts of the website regarding the in-between parts of everything. There are lots of pros and cons for the Barnett Continent Intestinal Reservoir and other factors with the process above that I will try to mention here at some point.