Living with a J Pouch

Seventy percent of Crohn's patients eventually require surgery to manage their disease. However, surgery may induce remission and provide relief from difficult symptoms, significantly improving patients' quality of life. One such method is J pouch surgery.

What is J pouch surgery?

J pouch surgery is a procedure to form an internal pouch from your small intestine. Your body uses this pouch to store stool—your body's waste products—if you've had your large intestine removed. J pouch surgery is also called ileal pouch reconstruction or J pouch reconstruction.

During surgery, your physician will create a new rectum using your ileum, the last part of the small intestine that attaches to the start of the large intestine. One of the main advantages of J pouch surgery is that it eliminates the need for a permanent external pouch to collect waste. However, patients must still have an intact anal canal to be a candidate for J pouch surgery.

Here, an overview of the procedure:

First, your physician will remove the diseased part of your colon. Using about two feet of your small intestine, he or she will create a loop from the end in the shape of the letter J. Closing the loop forms a pouch-the J pouch. Then your surgeon will create an opening so the pouch can attach to your rectal tissue in the anal canal.

To give the pouch time to heal, your surgeon will perform a temporary ileostomy further up in the small intestine, creating an opening in the abdominal wall (called a stoma). You will need to wear a temporary external pouch.

Four to six months later, once the J pouch heals from surgery, you will undergo a second procedure. Your surgeon will remove the temporary ileostomy and reconnect the bowel to the anal canal. This is called "taking down" the ileostomy. Now your J pouch is functional. As your body produces waste, the J pouch will store it until it's time to dispose of it, at which time it passes through the anus as a normal bowel movement. Once you've recovered from this second surgery, your bowel movements should return to normal.

Patients can resume most normal activities when they've recovered from J pouch surgery.