Print Full Guide
What is a J-Pouch?
When the colon (large intestine) and rectum are removed (due to chronic colitis, cancer or other colorectal diseases), another method must be devised for solid waste to exit the body. Surgically creating a “J” shaped reservoir, or J-pouch, out of an individual’s own small bowel (small intestine) is an alternate way for you to store and pass stool.
What are other names for a J-pouch?
Other commonly used names include ileal pouch and pelvic pouch. Similarly constructed ileal pouch types include the S-pouch and K-pouch (Kock pouch or continent ileostomy). Most patients at Cleveland Clinic receive a J-pouch, which is the current gold standard of surgical procedures.
How is it Created?
In a surgical procedure called a total proctocolectomy and ileal pouch anal anastomosis (IPAA), the entire colon and rectum are removed. A reservoir is created from the distal small bowel (called the ileum), which is then joined to the anal canal. This pouch serves as a storage place for the stool that the patient is able to pass through the usual route, eliminating the need for a permanent external bag (ostomy).
Who Is It For?
J-pouch procedures have become the gold standard for treating chronic ulcerative colitis (CUC) in which medical therapy fails to control symptoms. J-pouches also are used for familial adenomatous polyposis (FAP), colon and rectal cancer, and rare cases of Crohn’s disease.
Benefits
In a survey of patients who had J-pouch procedures at Cleveland Clinic, one of the greatest benefits cited was having control over bowel movements and being free from the need to instantly find a restroom.
Appointments
For additional information, visit clevelandclinic.org/digestive or call one of the following Cleveland Clinic locations:
- Cleveland: 216.444.7000
- Akron: 330.344.6699
Virtual Second Opinion
If you cannot travel to Cleveland Clinic, help is available. You can connect with Cleveland Clinic specialists from any location in the world via a phone, tablet, or computer, eliminating the burden of travel time and other obstacles. If you’re facing a significant medical condition or treatment such as surgery, this program provides virtual access to a Cleveland Clinic physician who will review the diagnosis and treatment plan. Following a comprehensive evaluation of medical records and labs, you’ll receive an educational second opinion from an expert in their medical condition covering diagnosis, treatment options or alternatives as well as recommendations regarding future therapeutic considerations. You’ll also have the unique opportunity to speak with the physician expert directly to address questions or concerns.
Why Choose Us?
The Cleveland Clinic Digestive Disease Institute’s Department of Colorectal Surgery began offering J-pouch surgery in 1983 and performs about 200 IPAA surgeries per year, having performed more than 3,600 to date. Cleveland Clinic has not only completed the greatest number of pouch surgeries of any hospital in the world, it also has the lowest pouch failure rate reported by any institution. Cleveland Clinic offers the traditional open approach, as well as a laparoscopic alternative.
While the procedure is complex and requires multiple steps that may or may not be accomplished with one surgery, the end result provides the majority of patients with positive outcomes that most feel outweigh the risks and possible complications.
In addition to performing the most J-pouch procedures in the world, the Department of Colorectal Surgery also is the largest national and international referral center for repairing failed pelvic pouches. Patients come from around the world to the Digestive Disease Institute for reoperations.
“I am a survivor of ulcerative colitis (UC). I was just surviving and living tied to a restroom. Taking medications and feeling bad were just part of my life. I am glad to say that is all in the past. I live a normal life. Yes, I use the restroom more frequently than others because my J-pouch is not as big as a colon, but I choose when I go. I have control. The only medicines I take are vitamins and my thyroid tablet.”
LaDonna Ashbrooks
Murfreesboro, Arkansas
Print Full Article
