J pouch surgery, or ileal pouch–anal anastomosis (IPAA), is commonly performed for ulcerative colitis and familial adenomatous polyposis (FAP) when the colon needs to be removed and patients want to avoid a permanent ileostomy.
Purpose
The colon is removed and a reservoir (pouch) is created from the small intestine (ileum) and connected to the anus, allowing stool to pass without a permanent external bag in most completed reconstructions.
Stages of surgery
IPAA is often done in stages:
- Remove the colon and create the ileal pouch in the pelvis.
- When needed, a temporary ileostomy to protect the pouch while it heals.
- Later reversal of the ileostomy so stool passes through the pouch and anus.
Recovery
Hospital stay is often about 5–7 days after major stages, depending on progress. Full adaptation of the pouch can take months. Patients typically have more frequent bowel movements than with a native colon; frequency often improves over time with diet, medications, and pelvic floor strategies when appropriate.
Risks and follow-up
Risks include infection, pouch leakage, stricture, pouchitis, and the possibility that a permanent stoma could still be needed in some cases. Lifelong follow-up is important.
To discuss whether J pouch surgery fits your situation, schedule a consultation.