In patients with ulcerative colitis that cannot be controlled by medications, surgical removal of the colon and rectum with creation of an ileal j-pouch is often the next step in management of the disease.
In this procedure, a portion of the ileum (small intestine) is reconfigured into a J-shaped pouch that takes the place of the rectum. The ileal j-pouch eliminates the need for a permanent ileostomy (see ostomy).
Ileal j-pouch surgery may be performed via an open or laparoscopic approach and usually involves two operations or “stages” and a temporary ileostomy.
Individuals with an ileal j-pouch should expect to live a normal, productive, and happy life. This ileal j-pouch procedure may also be used in some patients with Familial Adenomatous Polyposis (FAP) and a very select group of individuals with Crohn’s disease.
Ileoanal pouch anastomosis (image courtesy of the National Institutes of Health)