j-pouch surgery

[mikeandjean]

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

[CalGal]

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.

[Morecambe]

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

[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.

[CalGal]

I hope you'll find enough of an answer 'for you.' Be sure to ask LOTS of questions.