What is an ileal pouch?

In some cases of colorectal disease, such as chronic ulcerative colitis, familial adenomatous polyposis (an unusually large number of polyps in the colon), or colorectal cancer, all of the colon and rectum (large intestines) must be removed using a surgery called a total proctocolectomy.

After surgical removal of the large bowel, which absorb liquids and then stores and eliminates solid wastes, patients may be candidates for an ileal pouch-anal anastomosis (IPAA) procedure to provide a new way to store and pass stools the normal way, without a permanent bag.

The term “anastomosis” means a joining together of disconnected parts, like joining two pipes. In the case of an IPAA, the ileum (lowest part of the small intestine) is formed into a new reservoir to store solid wastes. This reservoir or pouch is connected to the anus to provide for elimination the normal way. The pouch enables the patient to store and pass stool through the body’s usual route, so that the patient doesn’t need an external bag to collect waste.

There are three different types of ileal pouches: J-pouch (the most common type), S-pouch, and the K-pouch. The J-pouch and S-pouch resemble the letters in the their names.

In order to have an ileal pouch procedure, the patient’s intestines, anus, anal sphincter muscles, and pelvic nerves must still be able to function normally. This will allow the person to maintain control of bowel movements once a pouch is constructed, and avoid bowel accidents.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy