Ellie Bradshaw – Biofeedback management for J pouch

Presented by Ellie Bradshaw – Pouch and Stoma Care Nurse at St Mark’s Hospital London.

Recorded on 29 May 2024 on behalf of the Red Lion Group.

The latest webcast in the RLG 2024 series took place on 29 May with Ellie Bradshaw talking about Biofeedback, a unique method of pouch emptying. Over fifty pouchees attended the event from the comfort of their own homes via zoom. Ellie is a highly experienced nursing specialist who used to be in charge of the Biofeedback unit at St Marks Hospital. She took a sabbatical to work at the Princess Grace Hospital in London and has now returned to St Marks to join the highly experienced and award winning pouch nurse specialist team. Her presence will add considerable capabilities and expertise to a team which is already world class. Ellie’s passion for helping pouchees was evident as she carefully walked us through the various ways in which pouchees can act and exercises they can do to improve and preserve their pouch function through control and strengthening of their pelvic floor. As well, she provided information on creams and medical devices which are available to pouchees and which can help to alleviate some of the common pouch issues, from which many of us suffer to a greater or lesser extent. In a lively and extended Q&A session Ellie was able to answer both broad and very personal pouch-related topics as diverse as sex for pouchees, night time incontinence, butt creams, stool thickeners, anus and lower back pain, how to achieve full emptying, probiotics, pelvic floor exercises and investigations when the pouch is not functioning well. The recording of the event is available on our You Tube channel – add link This was a compassionate and comprehensive talk packed full of practical tips and suggestions and some humour along the way to emphasise the messages. Another brilliant event from Ellie, who is a long-term supporter of the RLG charity, having been delivering talks for us since 2006. We are indeed grateful for all her support and delighted to have her back at St Marks. Thank you to all the attendees for such a great series of questions.

David Davies – RLG chairman

Prof John Nicholls – 40 years of colorectal surgery

We are delighted to announce that we will be kicking off our webcast season for 2024 with a talk from Professor John Nicholls, considered to be the the father of the ileo anal pouch (J Pouch). The Red Lion Group will be repeating its popular webcast series in 2024, providing an opportunity for J Pouch patients to see and hear from the foremost experts in the field of J-pouch surgery and the challenges of living with a J-pouch. As in previous years, each talk will be followed by an interactive Q&A so a chance to put your questions to the experts. The first event this year will be on Tuesday 16th April at 7:30 pm (BST) and will feature the eminent colorectal surgeon Professor John Nicholls, who will need no introduction to many of you. Not only was he the co-inventor, with SIr Alan Parks, of the procedure for ileal-pouch anal anastomosis (IPAA), but he has been responsible for the creation of more pouches than anyone on the planet earning him the sobriquet “the pouch king“. Professor John Nicholls is a retired British colorectal surgeon, Emeritus Consultant Surgeon at St Mark’s Hospital London and Professor of Colorectal Surgery at Imperial College London. He is also a Patron of the Red Lion Group.

Uchu Meade – Pharmacy advice for pouch patients

Uchu Meade – Pharmacy advice for pouch patients

Uchu Meade, Lead Pharmacist at St. Mark’s Hospital, London, speaking on behalf of the Red Lion Pouch Support Group, recorded on 10th August 2023.

In this talk, Uchu Meade explains how the altered physiology in pouch patients affects the absorption of different medications and looks at the different medications that are most frequently prescribed to pouch patients in regard to the common challenges faced by people with a pouch.

Kapil Sahnan – Advances in Robotic surgery

St. Mark’s Hospital has been pioneering a research programme into the use of robot technology in colorectal surgery, financially backed by St Mark’s Hospital Foundation. In this talk, Jason Bacon (CEO of St. Mark’s Hospital Foundation) and Kapil Sahnan (Consultant Colorectal surgeon at St. Mark’s) will give an update on this fascinating project. Compares traditional open surgery with laparoscopic and robot assisted laparoscopic surgeries.

NB. The original webcast included a short video of “live” robotic surgery which has been removed for privacy reasons, but the talk and content does not lose anything as a result of this edit.

Recorded on behalf of the Red Lion Pouch Support Group on 11 July 2023.

Pouch Nurse team – Innovations in pouch support and…

St. Mark’s hospitals award winning pouch nurse team featuring pouch nurse specialists Petya Marinova and Rali Marinova who were talking about “New trends and Innovation in Pouch Care and Ongoing support’ followed by a Question & Answer interaction with an audience of people with a ileoanal pouch (j pouch) or considering pouch surgery.

Some of the subjects discussed in the Q&A included :-

• Dealing with blockages
• Pouch emptying issues
• Vitamin B12 deficiency
• “Butt burn”
• Dehydration
• Catheterisation and enemas
• Educating GPs and other health professionals about pouches

Some of the links mentioned in the Q & A are below :-

https://pouchsupport.org/are-you-getting-enough-hydration-how-to-make-st-marks-solution/

https://pouchsupport.org/contacting-the-pouch-team-at-st-marks-hospital/

https://pouchsupport.org/j-pouch-and-vitamin-b12-deficiency/

https://pouchsupport.org/ileoanal-pouch-report-2017

https://pouchsupport.org/medic

Janindra Warusavitarne – Advances in laparoscopic approach to J…

Janindra Warusavitarne, a consultant colorectal surgeon at St Mark’s Hospital in London, is a pioneer in laparoscopic pouch surgery (sometimes known as keyhole surgery). Janindra, who is a patron of Red Lion Group, will compare the laparoscopic approach with the more traditional open J pouch surgery techniques.

This video was recorded on 16th May 2023 on behalf of the Red Lion Group.

About Mr Janindra Warusavitarne

Mr Janindra Warusavitarne, is a Consultant Colorectal Surgeon, specialising in intestinal failure, inflammatory bowel disease, Anal fistula, haemorrhoids and colorectal cancer.

He is the lead surgeon for inflammatory bowel diseases at St Mark’s Hospital, London, an honorary senior lecturer at Imperial College and conjoint senior lecturer at the University of New South Wales. He is part of the executive team conducting the European Board qualification for colorectal surgery and a visiting scientist to the Garvan Institute of Medical Research. In addition he sits on the education committee of the European Society of Coloproctology.

Janindra is considered a key opinion leader and innovator and has been involved in many new procedures such as video assisted fistula treatment and laser treatment for haemorrhoids and anal fistula.

Mr Warusavitarne relocated from Australia in 2010, when he was offered an appointment at St Mark’s Hospital in Harrow, a national and international referral centre of excellence for intestinal and colorectal disorders.

After completing his surgical training, Janindra undertook full-time research (focusing on the genetics of colorectal cancer) and was awarded a PhD from the University of Sydney, Australia. He has extensive experience in minimally invasive surgery and has been innovative in developing minimally invasive surgical techniques.

Ellie Bradshaw – Biofeedback in J pouch care

Biofeedback and the importance of the pelvic floor in J pouch care. Ellie Bradshaw, formerly gastrointestinal specialist nurse and biofeedback specialist at St Mark’s Hospital, now at Princess Grace. Ellie is also CNS (Clinical Nurse Specialist) Biofeedback, The Biofeedback Service at The London Digestive Centre.

Recorded on 26 April 2023 on behalf of the Red Lion Group.

Valerio Celentano – Ileoanal pouch formation and revisional surgery…

Valerio Celentano is Consultant Colorectal Surgeon at Chelsea & Westminster Hospital NHS Foundation Trust, and Head of J-Pouch One Stop Clinic at Chelsea & Westminster Hospital. Ileal pouch-anal anastomosis (IPAA) after total proctocolectomy (removal of entire large bowel and rectum) is a surgical procedure for ulcerative colitis refractory to medical treatment and majority of patients with familial adenomatous polyposis (FAP), as an alternative to permanent end ileostomy.

Although many patients undergoing pouch surgery have satisfactory functional and long-term outcomes results, the procedure is complex and associated with problems and complications in the short- and long-term. Several complications following pouch surgery can lead to the pouch requiring removal (pouch excision) or permanent diversion (need for ileostomy) and reported rates can be up to 20%. This spectrum of conditions carries the very unfortunate and likely inappropriate name of “pouch failure”. Gaining experience in pouch surgery is hard as the procedure is performed infrequently across many hospitals, as reported by the UK Pouch registry, outlining that the average number of pouches performed in English institutions was low and one quarter of the surgeons undertaking this operation had performed only one case over the last five years. The interactive talk will discuss the challenges of ileoanal pouch surgery and some of the surgical complications that can benefit from revisional (redo) pouch surgery.

An institutional initiative to promote standardisation of multidisciplinary care in IPAA surgery will also be presented. Contact Details:

For Valerio Celentano and Chelsea & Westminster web: www.chelwest.nhs.uk/ibd-surgery-centre

email: chelwest.j-pouch@nhs.net

This video was recorded on behalf of the Red Lion Group on 9 March 2023.