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J-Pouch Surgery for Ulcerative Colitis

OstomyLife Co-Moderator
05/13/19  8:00 AM PST
J-pouch surgery

Many people do not know what a J-pouch is. However, if you have Inflammatory Bowel Disease (IBD), chances are you have at least heard of this procedure. J-pouches are commonly used in the treatment of the IBD disease, ulcerative colitis, when medication management is not available.

What is J-Pouch Surgery?

J-pouch surgery, also referred to as ileal pouch anal anastomosis, is a procedure that allows removal of the colon without requiring a life-long ostomy. In this procedure, the colon (also known as the large intestine) and rectum are removed. Then the end of the small intestine is folded back on itself and sewn together to create a pouch. This pouch serves as a reservoir for stool until it is excreted. The J-pouch is then connected to the person’s anus so that stool held there is excreted normally.

While this procedure offers an alternative solution for ulcerative colitis that avoids the need for a life-long ostomy, one is needed temporarily. The surgery is usually a two-part endeavor:

  1. During the first surgery, your surgeon will remove your colon and rectum, create the J-pouch, and also create a temporary ileostomy for stool excretion. This will be used until your J-pouch has healed and is ready to work.
  2. For the second surgery (usually about 2-4 months later), your surgeon will reverse the ostomy and allow the stool to pass through the now healed pouch and be excreted as it was before surgery.

Adjusting to Your New J-Pouch

As you are healing from the J-pouch surgeries there will be some side effects as your body finds it’s new normal.

  • Usually, at first you will experience increased frequency of bowel movements. Although, it may not seem as frequent for those living with ulcerative colitis. After some time, as your pouch becomes more established, the frequency of bowel movements will decrease but may always be more frequent than someone without a J-pouch.
  • Pouchitis is something that can happen after surgery. It is when the pouch becomes inflamed and causes abdominal pain, diarrhea, fever, and increased frequency of and urge to have a bowel movement. Pouchitis can usually be treated with antibiotics and may require hospitalization.
  • Having a J-pouch means you do not have a colon, which is responsible for water absorption, so someone with a J-pouch may excrete more water in their stool and require more fluid intake to stay hydrated.
  • Click here to learn more about other side effects of receiving a J-pouch.

J-pouches provide an alternative to having an ostomy for individuals who are very sick and need to have their colon removed. Although this is the right choice for some, it is not for everybody. If you are considering J-pouch surgery, talk to your doctor and learn all you can about the procedure to decide if it is right option for you. Depending on the stage of the disease, you doctor will decide if it is appropriate treatment for your IBD case.


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I had emergency ostomy surgery last march. I have a peristomal hernia the size of a breast. Is that normal?
Manny
Unfortunately, hernias can often occur following ostomy surgery.
 
We definitely recommend speaking to your surgeon about the issue, but additionally ...


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  1. I had a J pouch. PLEASE… my doctor never checked to make sure my past diagnosis was correct. I lost my colon in an emergency sepsis surgery. My color eroded and leaked into my abdomen. At that time it was ASSUMED that I had Left sided colitis. Crohn’s quite often starts at the rectum, moving up the colon. After two of the most excruciatingly painful surgeries, and I’ve had 26 surgeries so I know about pain, I had to have the J pouch removed because the next Doctor tested me and found out that I actually had Crohn’s disease.

    My point is, please make sure that you actually don’t have Crohn’s disease before you have a j pouch made for you. I now have even less intestine because of the surgery. I’m still angry at that doctor for making my life worse and putting me through the most intense, horrible pain that I’ve ever been forced to endure. Crohn’s disease will not support A J pouch unless the data has changed and I’m not aware of it.

    My love and blessings to all who read this and who are affected by Crohn’s are any bowel disease. I pray that you have a better experience than me that you find Healing and a better life after your surgery. Much love!

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