J-Pouch

J-pouch or ileoanal anastomosis is a surgical procedure that allows you to get rid of your digestives wastes through an opening in the abdomen without needing to wear an ostomy bag. This surgery is also known as ileal pouch-anal anastomosis (IPAA) surgery.

The most common reasons you may need a j-pouch include chronic ulcerative colitis and other conditions that carry a high risk of cancer in the colon or rectum. In some cases, this procedure becomes inevitable when medications to treat ulcerative colitis fail to keep the condition under control. Cancer and precancerous polyps are also the reasons a person may need to undergo this procedure.

Risks

While this surgery can save you from many troubles related to ostomy pouch management, it can result in some complications and risks. Those risks or complications include dehydration, diarrhea, narrowing of the area between the anus and the internal pouch, and infection in the internal pouch (pouchitis).

Symptoms occurring due to pouchitis are pretty similar to those of ulcerative colitis. They include abdominal pain, diarrhea, dehydration, and fever. If you notice any of these symptoms, contact your doctor or nurse immediately.

On rare occasions, pouchitis may fail to subside with daily treatment. In such scenarios, the doctor may choose to remove the pouch and create an ileostomy.

What to expect

Before surgery

Before surgery, you will see a nurse who will mark the stoma site. The nurse will consider many factors while selecting the stoma site, including abdominal muscles, skin folds, navel, scars, hip bone, and waistline. Selecting a proper site is necessary because it makes stoma care easier after surgery.

Your doctor will recommend you a diet plan before surgery. He will ask you to avoid alcohol, caffeine, tobacco, and other drugs. Other changes in diet will depend on your body condition.

During surgery

The surgeon will opt for a minimally invasive procedure, such as laparoscopy, if possible. This surgical procedure involves one small incision that allows the insertion of a camera and surgical tools. Surgeons will maneuver these tools with the help of the camera. They will opt for open surgery if laparoscopy is not possible.

During the procedure, the surgeon will perform the following steps.

• Removing the entire colon and rectum, preserving the anal canal along with its sphincter muscles
• Folding the end of the small intestine into itself to create a J-shaped pouch and connecting it with the anal canal
• Contrasting a temporary stoma to allow the J-pouch to heal

After surgery

You will need to stay for a few days in the hospital after surgery. During this time, you will learn how to take care of your new excretory pathway. A nurse will help you learn everything.

Your doctor will recommend you drink a lot of fluids to avoid dehydration. He or she will ask you to add salts and other materials to compensate for the loss of electrolytes. Because you will not have the colon, the stools will be watery.

It will take around six months for you to recover from surgery. During this time, you will not be able to engage in strenuous physical activities like weightlifting, jogging, and aerobic exercises. Nonetheless, you will have to go for a walk to keep your bowels moving.

You can discuss any issue you face with your doctor or ostomy care nurse.