BCIR is not for people who have or need a colostomy, people with [active] Crohn's disease, mesenteric desmoids, obesity, advanced age, or poor motivation. When Crohn's disease only affects the colon, it may, in select cases, be appropriate to perform a BCIR as an alternative to a conventional ileostomy. If the small intestine is affected, however, it is not safe to have the BCIR (because the internal pouch is created out of the small intestine, which must be healthy).