Most people with ulcerative colitis never need surgery. However, living with such a condition for more than 30 years may lead to the need for surgery.
According to the Crohn’s & Colitis Foundation, J-pouch surgery is a more common option in cases where UC becomes unresponsive to medication.
In this article, we will discuss what j-pouch surgery is, what it does for UC, and its benefits and risks.
What is a j-pouch?
J-pouch, also known as a proctocolectomy with ileal pouch-anal anastomosis (IPAA), is when your surgeon removes the large intestine including the colon and rectum. He then folds the end of the small intestine to create a pouch. He then connects this pouch to the anus.
After this procedure, the patient retains sphincter muscles in the anal canal. These muscles contract and relax, allowing the patient to control bowel movements.
The best thing about this procedure is it leaves the anus in place. After the procedure, you will have continued continence without needing a stoma.
What happens during surgery?
The J-pouch has become one of the best solutions to treat colitis. Depending on your health, this surgery may involve more than one procedure.
During the first procedure, the surgeon will remove the colon and rectum. You will, however, retain muscles that surround your rectum and anus. He will then fold the small intestine into itself to create a J-shaped pouch. This pouch acts as an alternative to the rectum.
During the first procedure, the surgeon will create an ileostomy. He will create a small opening in the abdomen and bring the end of the small intestine out through this opening. He will stitch the edges of the small intestine with the abdominal skin. That will result in the formation of a stoma. You will have to wear an ostomy bag over your stoma to manage stool evacuations. Note that it will be only a temporary arrangement.
After 8-12 weeks, your surgeon will call you for another surgical procedure. During this procedure, he will reverse your ileostomy. It will involve reconnecting your bowel. From this point, you will be able to move your bowels like other people without ostomies.
What to expect after surgery?
After the first surgery, you will have to stay in the hospital for a few days. During this time, an ostomy care nurse will monitor your stoma and teach you how to care for it. You will also learn a lot about ostomy pouches during this time.
Once you recover from the impact of surgery, you will be prepped for other procedures involving your bowel reconnection. You will have to stay in the hospital for a few more days until you achieve your recovery.
A J-pouch comes with some risks too. Those risks or complications include:
- Small bowel obstruction
- Pouch failure
- Pelvic abscesses
Some women may find it difficult to get pregnant after j-pouch surgery.
Among other complications, pouchitis is the most common one. Doctors treat this condition with the help of antibiotics.
Remember, j-pouch surgery can help you retain the ability to move your bowels like a normal person. However, you have to be wary of its risks and complications. You can discuss everything with your doctor or surgeon.