For some people, an ostomy bag that collects poop outside their body is the only answer when they lose their colon. But for others, there are alternatives. The most common, J-pouch surgery, avoids a permanent ostomy by keeping things moving on the inside.
Treating colon conditions with surgery requires skill and experience. And you’ll find that at Cleveland Clinic. Our caring team will guide you through your J-pouch (ileal pouch) surgery and recovery. We listen to your concerns and answer your questions so you can feel confident about taking the next step.
Why Choose Cleveland Clinic for J-Pouch Surgery?
Trusted experts:
Cleveland Clinic began offering J-pouch surgery in 1983. Since then, our team has done thousands of surgeries — more than any other hospital in the world — and we continue to have the highest volume of surgeries. Meet our team.
Specialized knowledge:
We treat many different pouch-related conditions, ranging from inflammation and infection to Crohn’s disease of the pouch. Our team is recognized throughout the U.S. and the world for our expertise in pouch surgeries and ongoing care.
Collaborative care:
When you come to Cleveland Clinic for pouch surgery, you’ll have a team of expert providers from different specialties like colorectal surgery, gastroenterology and nutrition. Your providers work together to make sure you get the most personalized care every step of the way.
Patient-centered care:
People from all over the U.S. and the world travel to Cleveland Clinic for expert care and successful J-pouch surgeries. We make sure each person gets a carefully crafted treatment plan that meets their needs — before, during and after surgery.
Virtual visits:
After surgery, there’s no place like home. So, if you need a quick check-in with your provider, why not schedule a virtual visit? You can meet one-on-one online (and get the same great care) without ever leaving your house.
National recognition:
Cleveland Clinic is a trusted healthcare leader. We’re recognized in the U.S. and throughout the world for our expertise and care.
Understanding J-Pouch Surgery
Some conditions can severely damage your large intestine (colon and rectum), like:
- Inflammatory bowel disease.
- Ulcerative colitis.
- Toxic megacolon.
- Perforated colon.
- Familial adenomatous polyposis.
- Rectal cancer.
- Colorectal cancer.
Your healthcare providers may decide to remove your damaged large intestine. We call this a total proctocolectomy. And it means you’ll need a new way to poop. If other parts of your digestive system are working, you may be able to have ileal pouch surgery. This can allow you to keep pooping on the toilet.
J-pouch surgery, the most common, uses two loops of the small intestine to form a J-shaped pouch. This pouch replaces your colon and rectum internally. We attach the J-pouch to your anal canal so poop can move through it and leave your body in the usual way.
J-Pouch Surgery Consultation at Cleveland Clinic
Before you ever go into the operating room, you’ll meet providers from our digestive care team. This lets us get to know you and learn if a J-pouch is the best treatment for you — and your overall health.
What to expect during your consultation
During your visit, your provider will go over your medical history. They’ll also ask you a lot of questions about what’s been going on, like:
- What treatments have you already tried?
- What tests have you had?
- How is your condition affecting your quality of life?
Hearing your story and understanding your health history can help our team decide whether to move forward with J-pouch surgery.
Meet Our J-Pouch Surgery Team
Getting care at Cleveland Clinic means you’ll have a team of experienced providers from different specialties working together. This gives you highly personalized treatment with the best results. Your care team may have:
Providers Who Perform J-Pouch Surgery
Locations
Our healthcare providers see patients at convenient locations throughout Northeast Ohio and Florida.Getting J-Pouch Surgery at Cleveland Clinic
If our team decides you’re a good candidate for J-pouch surgery, we’ll do the process in two or three stages.
Large intestine removal
You’ll first have a total proctocolectomy. We may start the J-pouch process during this surgery. Or we may do it later in a separate surgery. Your care team will go over your surgery plan, so you know what to expect.
Temporary ileostomy
During the J-pouch process, you’ll need a temporary ileostomy to help you poop. Your poop will come out of an opening in your stomach (stoma) into an ostomy bag for a few months while your J-pouch heals.
Pouch testing
Eight to 12 weeks (two to three months) after surgery, we’ll test your pouch by doing a test called a pouchogram. We’ll run contrast solution through a tube in your anus and take X-rays. We want to be sure the pouch has healed completely and doesn’t leak.
Reverse ileostomy
We’ll reverse the ileostomy after testing your J-pouch. We want to be certain it’s ready to use. Once we’re finished with this surgery, you’ll be able to poop normally.
Life After J Pouch Surgery
It takes time for your body to get used to this big change. You may find yourself needing to poop much more often than usual at first — more than 10 times a day. That’s because the pouch starts out small. It can’t hold a lot but will gradually stretch out. This means you’ll eventually poop less — usually between three and 10 times a day.
You may need physical therapy to help you strengthen your pelvic muscles to make pooping easier. And you’ll also have regular visits with your healthcare providers to make sure everything is working correctly with your J-pouch. You’ll have a test called a pouchoscopy each year, too.
Using a small camera, your team will check the J-pouch for complications like:
- Pouchitis.
- Twisted pouch syndrome.
- Strictures and stenosis (narrowing, blockages and stiffness).
If you have an infection like pouchitis, you’ll probably need to take antibiotics. For pouch narrowing, we may need to re-stretch your J-pouch using a tool called a dilator. If your pouch twists or kinks or has blockages, you may need surgery to repair it. We’ll try to save the pouch and make it work again if possible.
Our team will also help you find the best ways to stay hydrated and eat a balanced diet. Doing this may help control diarrhea and inflammation. A dietitian can help you find the best eating plan for your needs.
Taking the Next Step
Learning you need to have your damaged colon removed probably isn’t the news you wanted to hear. But our expert providers know what it takes to build a way to help you keep using the bathroom like usual. You’ll have a caring, experienced team on your side. We make sure you get the most personalized care — and the best possible results.
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