What To Expect From J-Pouch Surgery

One of the ways to treat severe disease or injury affecting the colon is the ileal pouch-anal anastomosis (IPAA) procedure, also known as the J-Pouch procedure. This procedure aims at removing the diseased part of the colon and allows the patient to evacuate fecal materials through the anus.

This procedure involves surgical removal of the colon, creation of a pouch by folding of the end of the small intestine into itself, and connection of that pouch with the anus. The patient may have to wait for a few days for this pouch to become functional.

J-pouch can have multiple names depending on the stage of surgery and the country in which surgery is being performed. The other names of the ileal pouch-anal anastomosis include j-pouch, ileo-anal reservoir (IAR), ileo-anal pouch, restorative proctocolectomy, internal pouch, Kock pouch, ileal-anal pull-through, and ileostomy takedown.

Why may you need j-pouch surgery?

The primary prerequisites for j-pouch surgery include an ileostomy and the patient’s willingness and eligibility to have this internal reservoir. The doctor makes sure that your anal sphincters are strong enough to control the fecal evacuation when there is a bowel movement.

Severe cases of inflammatory bowel disease may also lead to a person requiring a j-pouch. Such cases generally result in more than 25 bowel movements a day. Giving those patients a j-pouch can help them reduce and regularize bowel movements, making it possible for them to return to their active daily routines.

Who is the candidate?

The surgeon will make the final call whether or not you are the right candidate for a j-pouch. The decision will base on the following factors.

• The status of your overall health
• What is the type of problem in your colon?
• What is the severity of the problem?
• Will the removal of the colon fix your problem?
• What are the possible risks involved in the procedure?

The procedure

You may require more than one surgical procedure to have a j-pouch. During the first procedure, the colon will be removed. The surgeon will give you an ileostomy until you recover enough to be able to undergo another surgical procedure that aims at the creation of the j-pouch, which is a reservoir meant to be connected to the anus.

The surgeon will most typically perform the second operation three months after the first procedure. During this procedure, the surgeon will fold the end of the small intestine to form a j-pouch or reservoir. This reservoir will have an opening that will pass the stool to the anus.

The j-pouch, or reservoir, not only stores the stool, but it also has strong muscles that allow the bowel movement to happen only when it’s time. With the help of anal sphincters, you will have some or total control over the timing of stool evacuations.

After surgery

You should expect your body to take some time to adapt to the new normal after surgery. Because you will not have the colon, the consistency of your stool will not be hard, but you can expect it to settle down to that of paste. You may have to go to the toilet 5–6 times a day.

You may have to make adjustments in your diet plan to avoid any complications related to the bowel movements. You can talk about it with your doctor or ostomy care nurse.