J Pouch

Here is a small section about the J Pouch or Ileoanal Pouch, that I have sourced around the web. I have put links on my blog roll to the sites that have more information, some can be rather technical.

I’m going to be doing more work on this page, over the next few weeks. Hope to get more up to date information for you. I will also put her my veiws on some of the things Doctors say about living with a Pouch.

This is perhaps the most popular of the surgical procedures. The formation of the J Pouch can be done in 1, 2, or 3 steps, depending on the surgeon and the overall health of the patient.

In step 1, the colon (large intestine) is removed leaving the rectum in place. The end of the small intestine is temporarily brought to the surface of the abdominal wall as an ileostomy. Three to six months later, step 2 is performed.

In step 2, the surgeon will loop together a section of the small intestine and move it down to form a reservoir near your rectum. The rectum is stripped of its mucosal layer before the reservoir/pouch of small intestine is attached. About 3 months later, step 3 is performed.

In step 3, often referred to as your “take down,” your ileostomy stoma is closed and waste now passes on to the reservoir and is expelled through the anus. People report step 3 as the easiest of the 3 surgeries.

ADVANTAGES to this procedure:

* the ability to pass stool “normally,” sitting on the toilet

* no external appliance

DISADVANTAGES to this procedure:

* pouchitis (a serious, painful, common, and sometimes chronic infection of the reservoir)

* frequent bowel movements

* the development of abcesses and fistulae, even if you did not have those problems before surgery

* “Butt Burn” (skin irritation caused by the frequent passing of highly acidic stools)

* strong smelling, loud-passing stools

Q and A

HOW MANY BOWEL MOVEMENTS A DAY CAN I EXPECT?

At first, many people have 10-20 liquid bowel movements a day. But as your body adjusts, ideally, the number should decrease to about 5 or 6 stools a day. You will eventually learn which foods pass through you too quickly or have trouble passing. Also, without the large intestine to solidify the stool, stools will be fairly liquid to soft in texture.

Myself, I empty Pouchie 7 times in a day, sometimes more sometimes less. It all depends on what you eat. So if you eat Pouch friendly foods during the day you movements could be fewer. Having the pint of lager and a curry in the evening, you could be in trouble!

WHAT IS THE USUAL RECOVERY TIME FOLLOWING THIS SURGERY?
Pain subsides considerably after the first 3 days, and most patients begin to withdraw pain meds after a few days at home. Recovery time varies. If you have the entire surgery done in one step, recovery time is the usual recovery time for major surgery, 6-12 weeks. If you have the surgery in three steps, the first step is the hardest and takes the longest to recover from (6-12 wks), but the subsequent surgeries will have a shorter recovery time.

I had a one step operation.  Although I was rather sore and swollen, I went back to university 3 weeks after I left hospital.  I keep duties light but found walking about and keeping active helped in my recovery.

WILL ANYONE BE ABLE TO TELL I’VE HAD THIS SURGERY?
You can expect a scar from the temporary ileostomy and a larger one from the surgery itself. But other than that, there are no outward signs.

If you want people to know!  Most of my friends knew I was ill so knew when I had the operation, as I looked and felt better.  My scar has faded and only the line can be seen in certain light.  If you were short crop tops, people will see it – simple as.

WILL MY DIET BE LIMITED AT ALL?
You eat a soft diet for the first 2 weeks after surgery, nothing fried, spicy, or heavy roughage. Once your body adjusts, there are no specific food restrictions. You will learn through trial and error which foods may give you trouble. If you were lactose intolerant before surgery, you may still be.

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9 thoughts on “J Pouch

  1. Kevin C. says:

    hello. i have had my takedown 2 years ago. every now and then i get sores inside my rectum. at least thats what it feels like. anytime i pass stool it burns and feels like razorblades are going through me. and sometimes i get an itchy feeling. do you know what causes these?

    • Hi there Kevin! It could be a number of things. Butt Burn is caused by acid build up or general irritation from the pouch. Normally I would use a barrier cream, preferably with an anaesthetic. Some other conditions are Pouchitis or maybe ulceration. You could try a couple of remedies to try and calm your pouch down. Have a day or two of “safe” foods like plain bread, chicken, no acid, no course or rough foods. If this doesn’t help, go and see your doctor in case it’s more complicated.

  2. Anna says:

    Hi there
    I’ve had my 1st op (removed colon) and now due for the 2nd op end of January.
    My concern…recovery time after my 1st op took very long (I was very ill though).
    How long after the 2nd op (reconstruction) will it take to be back at work? I’ve got a bride that wants me to do flowers for her wedding (19th March) and I’m concerned if I should take this on or not. Thanks

    • Hi Anna

      If you have recovered from the effects of UC then you will be only recovering the operation itself. It will depend how they are going to cut you and the amount of work you’ll be having done. I had a one step op so my recovery time was about 4 to 5 months. I was back at University after 4 weeks of the operation, I wasn’t quick on my feet and couldn’t carry anything too heavy but I was fine.

      With your pouch being new, watch what you eat for the first month. Only eat soft foods that don’t scratch, that is not too acidic, foods with Gelatine and use moist wipes and barrier creams to protect the outside. If your operation is in January then I believe you will be fine in March, just take it easy and don’t try and do too much too soon.

      Good luck for your operation – you will be fine!

  3. Manpreet says:

    Hey,

    Okay, here is my story. I used to be a gym addict, had the body of a greek god while i was suffering from UC and loosing blood all the time. Even after my blood tranfusion i went to the gym to work out. HaHa. anyways, I had my 1st operation and the recovery time was a disaster. But after a month i got back to somewhat of my old routine and started going back to the gym. My 2nd surgery is going to be making the j pouch and also the takedown, step 2 and 3 combined. I was wondering what is the recovery time from that surgery?

    • Welcome Manpreet

      Normally 6 weeks after surgery you will be more healed internally to do more heavy work. I returned to Uni after 4 weeks of my pouch being done and was more or less active after 4 months after surgery. My problem was I wasn’t very fit before my operation and took longer than normal to recover. If you go to the Gym to do weights I would discuss a routine with your surgeon and Gym helper to avoid damage. If you go and do light exercise then take things slow and build up gradually.

      I also had a one step, which means I had everything done in one long operation, so I had a lot more inside to recover than maybe those who have 2 or 3 step. You will know how far to take things after your operation.

      Good luck with everything and let em know how you get on!

      Moo x x

  4. Manpreet says:

    Hey just for an update, my 2nd surgery is on March 22nd and my surgeon said he would complete both step 2 and 3 during this operation. My weight is rocketing now that i can eat foooood! I weight 163, i was 180 but left the hospital after my first surgery 143, I been hitting the gym everyday, gradually building up the weights, actually very consistent and harder now because i have the energy though before i didnt because i was never feeling good. I just hope i dont loose alot of weight during this surgery, but i guess as a benefit, i am going into my next surgery healthy, rather ill like before.

  5. what causes ulcers in the j pouch…is the type of foods one eats or the lack of water one drinks or not eating more small meals each day? thanks. my last surgery was in 3/2008 and i am doing fantastic but worried about ulcers developing.

    • Hi Mason, I don’t know what causes the ulcers to develop, I believed mine was due to my immune system attacking my colon.. I believe if you have IBD the best cause of action is to eat healthy and sensibly. I eat food that I know has benefits to my pouch. I don’t eat anything acidic or rough, for example orange juice, lemon or wholegrain bread. This is to stop degeneration of the pouch and the lining of the intestine. You should be drinking more water per day than a normal person due to the watery consistency your output can be. If you are happy with the way things are at present then continue as you seem to be doing well. People I know who have IBD and have problems are usually drinking beer, eating fast food and spicy food all the time and they digestion system isn’t as strong as it was before. If you are still concerned about your eating habits, maybe see if you can visit a dietitian and they can explain how food react with your condition – good luck and fingers crossed you will be well for many more years!!

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