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j-pouch surgery

by mikeandjean, Jul 03, 2008 08:56PM
I'd posted earlier, telling of my wife's situation with a pre-cancerous polyp and a history of previous colon cancer. We met with our surgeon and he's recommending a total procto-colectomy with an ileo-anal anastomosis. He would remove the remainder of the colon, including the rectum. The small intestine would be connected to the anus. He would create something called a j-pouch out of the end of the small intestine. This j-pouch is meant to replace the rectum for storage of waste. Full control of bowel movements is retained. I'm wondering if anyone has experience with this surgery and would be willing to tell us what life would be like post surgery. We have not definitely said we'd go with the ileoanal surgery instead of the ileorectal. The problem with keeping her rectum is that her genetic predisposition to colon cancer would leave us with a significantly raised risk for future cancer. The benefit of the ileoanal surgery is that the risk of further colon cancer drops very close to zero.
Thanks.
Michael
Member Comments (8)

by CalGal, Jul 03, 2008 10:19PM
To: Michael
If you don't get any response, you may want to try on some Inflammatory Bowel Disease (IBD) boards. This form of surgery is often used by those with ulcerative colitis.

by Morecambe, Jul 04, 2008 06:54AM
To: mikeandjean
Hi - I remember placing a reply to your earlier posting.  I underwent the "ileo rectal" rather than the "ileoanal" surgery so I can't respond on the experience of the J pouch.

However, if I were in your situation I suppose I would ask the following questions:-

- is the "defecating experience" after the ileoanal/J pouch worse/more troublesome than the defecating experience after the ileorectal??  In other words does the experience of the J pouch impinge on your life to a much greater extent for whatever reasons??

- if so, then is it possible to undergo the ileorectal procedure, then keep a close eye via regular sigmoidoscopies on the state of the rectum, and then if the rectum starts to look "pre-cancerous (or whatever) convert the "ileorectal" into an "ileoanal".  Can one assume that if in the future, the ileorectal is converted to an ileoanal, then the removal of the cancerous rectum will not have increased the risk of any metastising elsewhere??

Good luck
Morecambe

by mikeandjean, Jul 15, 2008 11:25AM
To: mikeandjean
I took CalGal's suggestion and did some research (via Google) on IBD. Sure enough, there is plenty of information, both professional and personal, about the J-pouch surgery. Sounds like a very promising route for us, with a good bit of experience out there with j-pouch surgery.

by CalGal, Jul 15, 2008 04:40PM
To: Mikeandjean
I hope you'll find enough of an answer 'for you.' Be sure to ask LOTS of questions.

by debbie207, Jun 18, 2009 05:02AM
To: mikeand jean
i am just about to go through the same thing in a couple of weeks,i have had a large amount of large bowel removed already due to  polps the ones i have has a really long name to it and is really rare so they say in such a young age i was 27 when there first found them now im 32. i am really unsure of what to except they said they would join the small one up to some pouch is that the j pouch you mentioned?? i belive for myself this is the best suggestion cause they can never remove the lot of them at once and they just keep growing and im always at risk of cancer. i have had a stoma before and do you know if this op is likey to have the same outcome or is it just if things go wrong again, i really need to talk to the doctor again i know. can you help me with any information you may no?

by TrudieC, Jun 18, 2009 07:16AM
Yes, this would be the J-Pouch.  If things go wrong you could have a stoma again but odds are good all will be fine.  I had my J-Pouch done 16 years ago and have had such success.  The first 6 months are quite challenging but be vigilant in adjusting your meds and diet and you will get there.  It is so worth it.

by katy55, Oct 25, 2009 03:52PM
To: mike and jean
I no not know if you have had your surgery or not yet but I have a j pouch which I have had for 14 years and I have had no problems going to the toilet about 5 times a day mostly at night or in the early morning.Just lately I have been getting a lot of pains in my stomach and i have been told it is the scar tissues and the pain is unbelievable has any one else got the same problem.

by niki26, Nov 22, 2009 11:32AM
To: Mike and Jean
Honestly if I could go back in time I wouldnt have gotten the removal of the large intestine and a j-pouch... since i've gotten that surgery 6 years ago i've had nothing but problems with it. Although i have Ulcerative Colitis and that could be one of the reasons. Just make sure you get a second opinion. Like the poster  trudie said the first 6 months r usually difficult because of the healing time. And for awhile you'll always wanna kno that there is a bathroom close by.
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