J-Pouch Surgery

Thank you to Bonnie & Andrew Stern for supporting the development of this video.


J-Pouch Procedure

If your ulcerative colitis inflammation and symptoms have not been controlled by medications, your doctor may have recommended a common type of surgery to construct an ileal pouch anal anastomosis, or (IPAA). It involves removing the colon and rectum to form what is often referred to as a j-pouch. This surgery may occur in one, two, or three stages depending on your health. Below is a description of the most common procedure, involving two stages. View the animated video above for this description.

During the first surgery, the colon and rectum are removed, and a pouch, commonly in the form of a J, is created at the end of the small intestine and joined to the top of the anal canal. At the same time, a temporary opening known as a loop ileostomy is created. The ileostomy will allow waste to pass through the abdominal wall into an ostomy bag while the newly formed pouch heals.

The second surgery occurs after 8 to 12 weeks, once the pouch is healthy. At this time the ileostomy is closed and the two ends of the bowel are reattached. Waste is now able to pass through the small intestine, collect in the pouch, and be expelled through the anus.

Common side effects

After the surgery is complete your body will need time to adapt to the pouch. Some patients may experience an increased number of bowel movements, but this will typically decrease after some time. Another side effect known as pouchitis involves inflammation of the pouch. Most cases are temporary and respond well to antibiotic treatment. In certain instances, sexual function may also be affected as nerve damage may lead to male sexual dysfunction. In females, scar tissues may surround the ovaries and fallopian tubes which could lead to infertility. You should talk with your surgeon about these risks and ask when it is safe to resume sexual activity.

Your doctor and healthcare team will work with you to help you understand all of the risks and benefits of the j-pouch.

For more information about surgery for inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, view our educational brochure.

For further information, call Crohn's & Colitis Foundation's IBD Help Center: 888.MY.GUT.PAIN (888.694.8872).

The Crohn's & Colitis Foundation provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organization's resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

About this resource

Published: May 5, 2017

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