Introduction:
J pouch surgery, also known as ileal pouch-anal anastomosis (IPAA), is a surgical procedure commonly performed for patients with ulcerative colitis or familial adenomatous polyposis (FAP). This handout provides essential information about J pouch surgery, including its purpose, procedure, recovery, and potential risks and benefits.

Purpose of J Pouch Surgery:
J pouch surgery treats conditions such as ulcerative colitis and FAP, which can cause chronic inflammation, pain, and other gastrointestinal symptoms. The procedure involves removing the colon and creating a reservoir from the small intestine (ileum) to replace the removed colon, allowing stool elimination through the anus.

The procedure:
a. Pre-operative preparation:
Before surgery, you will undergo a thorough evaluation, including blood tests, imaging studies, and possibly a colonoscopy. Your surgeon will explain the procedure in detail, answer any questions you may have, and provide instructions for preparation, such as fasting and bowel cleansing.
b. Surgery:
The surgery is typically performed in two or three stages, depending on the individual's condition and surgeon's preference:
Stage 1: Remove the colon (colectomy) and create the ileal pouch inside the pelvis.
Stage 2 (if necessary): Creation of a temporary ileostomy, where the small intestine is brought out through an opening in the abdominal wall to allow waste to bypass the J pouch while it heals.
Stage 3 (if necessary): Reversal of the ileostomy, allowing stool to pass through the J pouch and the anus.

Recovery and Post-operative Care:
a. Hospital stay:
Following J pouch surgery, you can expect to stay there for 5 to 7 days, depending on your progress and any complications.
b. Pain management:
You will receive pain medication to manage post-operative pain. Your surgical team will monitor your pain levels and adjust the prescription accordingly.
c. Diet and nutrition:
Initially, you may receive food through an intravenous line (IV) to allow the J pouch to heal. Once your digestive system recovers, you will start with a liquid diet and gradually transition to solid foods under the guidance of a healthcare professional.
d. Stoma care (if applicable):
If a temporary ileostomy were created, you would need to learn stoma care, including how to clean the stoma, change the pouching system, and manage any potential complications.
e. Follow-up appointments:
You will have regular follow-up appointments with your surgeon to monitor your progress, address any concerns, and discuss further treatment or medication adjustments.

Potential Risks and Benefits:
a. Risks:
As with any surgery, J pouch surgery carries certain risks, including infection, bleeding, bowel obstruction, pouch leakage, pouchitis (inflammation of the J pouch), sexual dysfunction, and fertility issues. Your surgeon will discuss these risks with you in detail before the procedure.
b. Benefits:
J pouch surgery can significantly relieve symptoms associated with ulcerative colitis or FAP, including abdominal pain, diarrhea, rectal bleeding, and urgency. It can restore quality of life, eliminate the need for a permanent ostomy, and allow regular bowel movements.

Conclusion:
J pouch surgery is a complex but effective procedure that can significantly improve the quality of life for individuals with ulcerative colitis or FAP. It is essential to have open and honest discussions with your healthcare team to fully understand the procedure, its potential risks and benefits, and what to expect during recovery.