If you need to have an ileostomy, you might want to have a Kock pouch with it. The K-pouch is an ileal pouch that attaches to your stoma on the inside. Instead of an ileostomy bag, the Kock pouch collects your poop inside your body until you’re ready to drain it. You can drain it into the toilet by inserting a catheter into your stoma.
An ileostomy redirects the end of your small intestine, called the ileum, to an opening (stoma) in your abdomen so that you can pass waste from your body. With a stoma, you need a pouch to collect waste.
If you have a standard (Brooke) ileostomy, you’ll use an external pouch (ileostomy bag) that attaches to your stoma to collect your waste (poop). You’ll remove the pouch to empty it throughout the day.
The Kock pouch is an alternative, internal pouch that your surgeon can construct to hold your poop inside your body. It attaches to your stoma, and you can empty it at your convenience through a tube.
The Kock pouch is an option for people who have to have a permanent ileostomy but don’t want to use an external ileostomy bag. It offers the ability to hold your poop inside your body and empty it at will.
An ileostomy with a Kock pouch is also called a continence ileostomy. That’s because it prevents the fecal incontinence that usually comes with a stoma — poop coming out any time.
The Kock pouch that we use as a fecal continence pouch today was originally designed as a urinary continence pouch. It was used to replace your bladder if you had to have your bladder removed.
A urostomy Kock pouch holds your urine and allows you to drain it through a catheter inserted into a stoma. It’s still in use, although many newer urinary reconstruction and diversion models exist today.
The Kock pouch is named for Nils Kock, the surgeon who invented it.
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Your surgeon can create your Kock pouch at the same time they create your ileostomy, or they can create it later in a separate surgery. You can have a Kock pouch procedure any time after an ileostomy.
To construct the pouch, your surgeon will:
After K-pouch surgery, you’ll recover in the hospital for three to five days. During this time, you’ll have various tubes placed in different parts of your body to help you recover. These may include:
The catheter in your stoma will stay in place for several weeks to drain fluids from your Kock pouch wound. A nurse will instruct you on caring for your catheter until a healthcare provider removes it.
You’ll spend a few weeks recovering at home before the wound drain can be removed. After that, a nurse will teach you how to drain your K-pouch with the regular catheter you’ll use from now on.
You’ll have to drain the pouch about eight times a day in the beginning. After a few months, when your pouch has fully healed and gradually enlarged, you’ll only need to drain it two to four times a day.
The primary advantages of a continence ileostomy over a standard ileostomy are:
Possible complications include:
Most people choose the Kock pouch to make their lives easier, and, by design, it does. Whether you’re converting from a standard ileostomy or a failed J-pouch, the K-pouch is an answer to several problems.
But the Kock pouch does have a higher rate of complications that require revision surgery than other pouches do — up to 30%. This is mostly due to valve failures, which are unique to the Koch pouch.
Despite these setbacks, most people report improved quality of life with the K-pouch. You’ll discuss your personal risks, alternatives and health thoroughly with your healthcare provider before going forward.
A balanced, nutritious diet will help you restore your overall health. You may have developed limited eating habits in the past to manage your chronic disease. Now you can start to broaden your diet again.
A registered dietitian can help you develop a personalized diet that meets your nutritional and hydration needs. If your stool is too thick or too runny, dietary adjustments can help with this, too.
The K-pouch was the first ileal pouch that was introduced for people having ileostomy surgery. It offered people living with a permanent ileostomy a way to maintain some control over their bowel movements.
The J-pouch is a newer breed of ileal pouch that offers an alternative to having an ileostomy at all. This ileal pouch attaches to your anal canal so you can poop the old-fashioned way, without a stoma.
The K-pouch remains an alternative for people who can’t have a “restorative” proctocolectomy that reconnects their bowel to their anus. It’s also a backup option if your J-pouch fails due to complications.
A Kock pouch is an option that you can have with an end ileostomy. It’s the only ileal pouch that works with a permanent ileostomy. An ileostomy with a Kock pouch is also called a continence ileostomy.
A note from Cleveland Clinic
If you’re contemplating a Kock pouch, you’ve already made the bigger decision to have a major bowel resection. This should bring relief from the chronic disease that made your intestine unusable.
While proctocolectomy might save your life, the Kock pouch exists to improve your quality of life. When pooping is easier, everything is easier, and you can begin to reclaim more of your favorite activities.
Last reviewed by a Cleveland Clinic medical professional on 05/18/2023.
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