Ileoanal anastomosis (J-pouch) surgery
About this test
Ileoanal anastomosis surgery removes the large intestine and makes a pouch inside the body that allows a person to get rid of stool in the usual way. The surgery (pronounced il-e-o-A-nul uh-nas-tuh-MOE-sis) also is called J-pouch surgery and ileal pouch-anal anastomosis (IPAA) surgery.
Why it's done
Ileoanal anastomosis surgery is most often used to treat long-term ulcerative colitis that medicine can't control. It also treats conditions passed through families that carry a high risk of colon and rectal cancer. An example is familial adenomatous polyposis (FAP). Sometimes the procedure is done if there are bowel changes that could lead to cancer. And it's sometimes used to treat colon cancer and rectal cancer.
Risks and complications
Risks of J-pouch surgery include: Blockage of the small bowel. The body losing more fluid than it takes in, called dehydration. Diarrhea. Narrowing of the area between the pouch and the anus, called stricture. Pouch failure. Infection of the pouch, called pouchitis. Pouchitis is one of the most common complications of ileoanal anastomosis. The risk of pouchitis increases the longer the J-pouch is in place. Pouchitis can cause symptoms like those of ulcerative colitis. These include diarrhea, abdominal pain, joint pain, fever and dehydration. Contact your healthcare professional if you have any of these symptoms. Most often, antibiotics can treat pouchitis. A few people need daily medicines to treat or prevent pouchitis. Rarely, pouchitis doesn't respond to daily treatment. Then surgeons may need to remove the pouch and make an ileostomy. An ileostomy involves wearing a pouch outside the body to collect stool. Removal of the J-pouch occurs in only a small number of people with a J-pouch. Often as part of the surgery, the pouch is sewn to a small section of rectum called the cuff that remains after removing the large intestine. For people with ulcerative colitis, what's left of the rectum may become inflamed with colitis. This is called cuffitis. For most people, cuffitis can be treated with medicine.
Understanding your results
Most people who have J-pouch surgery report a good quality of life. Around 90% of people are happy with the results. Within a year after J-pouch surgery, most people have fewer bowel movements than they did right after surgery. Most people have 5 to 6 bowel movements a day and one or two at night. J-pouch surgery doesn't affect pregnancy or delivery. But it may affect being able to get pregnant. If you want to be able to get pregnant, talk with your healthcare professional about the best approach for your surgery. Nerve damage might cause some erection problems after the surgery. J-pouch surgery is most often chosen over a long-term ileostomy, which involves passing stool into an ostomy bag worn outside the body. Discuss with your healthcare professional which surgery is better for you.
Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.