The continent ileostomy, or Kock pouch, is an option for people who would like their ileostomy converted to an internal pouch. It's also an option for people who do not qualify for the ileal pouch anal anastomosis procedure. In this procedure, there is a stoma but no bag. The colon and rectum are removed, and an internal reservoir is created from the small intestine. An opening is made in the abdominal wall, and the reservoir is then joined to the skin with a nipple valve. To drain the pouch, the patient inserts a catheter through the valve into the internal reservoir. This procedure, however, is not the preferred surgical treatment for ulcerative patients. That's because of its uncertain results and the potential need for additional surgery.