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Having Bowel Surgery: Ileoanal Pouch

This surgery is done to treat diseases of the digestive tract. It takes out all of the large intestine. When healed, bowel movements still occur through the anus.

The pouch is also called a "J-pouch" for the shape of the pouch.

Preparing for surgery

You'll start getting ready a few weeks before surgery. You may need to do the following:

  • If you smoke, get help from your healthcare provider to quit.

  • Tell your healthcare provider about any medicines you take. These include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and blood thinners. Also tell him or her about any herbs or supplements you take. Ask whether you should stop any of them before surgery.

  • If you will have a stoma, a specially trained healthcare provider called an enterostomal therapy (ET) nurse will meet with you. The ET nurse will help you find the best place for the stoma on the abdominal wall.

  • Follow any directions you are given for taking medicines and for not eating or drinking before surgery. This includes any instructions for bowel prep.

The procedure

  • The colon and rectum are taken out.

  • The anus and surrounding muscles are left in place.

  • Part of the small intestine is reshaped to form a pouch within the body. The pouch works like a rectum. It stores waste until a bowel movement occurs.

  • A temporary ileostomy may be needed as the intestine heals. This is a procedure that lets waste pass into a pouch outside the body.

Risks and possible complications

Bowel surgery has some risks and possible complications. Your healthcare provider can talk about them with you. They may include:

  • Infection

  • Injury to nearby organs

  • An anastomosis that leaks

  • Blood clots

  • Risks from the anesthesia

  • Pouch inflammation or malfunction

Diarrhea is very common after surgery. Over weeks to months, the bowel gets closer to normal. But most people end up with more frequent and softer bowel movements than before. Sometimes a bowel movement occurs overnight. If your healthcare provider thinks the pouch may have a problem, he or she can put a flexible tube (a scope) inside it to look around and find out what is wrong.

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