J-pouch
A J-pouch is an internal reservoir a surgeon makes from the end of the small intestine and connects to the anal canal, so a person can pass stool the normal way instead of living with a permanent stoma. It is most often done for ulcerative colitis after the colon and rectum are removed.
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A J-pouch is an internal reservoir a surgeon builds from the end of the small intestine (the ileum) and connects to the anal canal. Its name comes from its shape: loops of small intestine are folded into a "J" to form a small holding pouch where stool can collect (Cleveland Clinic). The medical term is ileal pouch-anal anastomosis, often shortened to IPAA.
The point of a J-pouch is that it lets a person pass stool the normal way instead of living with a permanent ileostomy and an ostomy bag, as long as the anal sphincter muscles work well enough to keep control (Cleveland Clinic).
Who it is for
A J-pouch is most often done for ulcerative colitis when medicines no longer control symptoms, and sometimes for a hereditary condition called FAP. In each case it follows removal of the colon and rectum (Crohn's & Colitis Foundation).
How the surgery is staged
J-pouch surgery is usually done in two to three stages. It begins with removing the colon and rectum, then building the pouch. A temporary loop ileostomy is made at the same time so waste can leave the body while the new pouch heals, and that temporary stoma is later reversed, often after about 8 to 12 weeks (Cleveland Clinic; Crohn's & Colitis Foundation).
A common thing to know about
The most common complication is pouchitis, inflammation inside the pouch. It happens to up to about half of people with a J-pouch, usually within the first couple of years, and is generally treated with antibiotics (Crohn's & Colitis Foundation). Whether a J-pouch is the right choice, and what to expect from it, are questions for your surgical and IBD team.