Having Bowel Surgery: Ileoanal Pouch

This surgery is done to treat diseases of the digestive tract. It removes 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

Preparation may start a few weeks before surgery and can include the following:

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

  • Tell your doctor about any medicines (including aspirin, NSAIDs, and blood thinners), 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 determine the optimal location 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.

Image of the intestines with the colon and rectum highlighted to show the section to be removed.

Image showing the intestinal pouch for collecting waste

The procedure

  • The colon and rectum are removed.

  • 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 complications

Bowel surgery has certain risks and possible complications. Your healthcare provider can discuss them with you. They may include:

  • Infection

  • Injury to nearby organs

  • An anastomosis that leaks

  • Blood clots

  • Risks related to anesthesia

  • Pouch inflammation or malfunction

Diarrhea is very common after surgery. Over weeks to months, the bowel returns closer to normal. But, most people end up with more frequent and softer bowel movements than before. Sometimes a bowel movement occurs overnight. If the pouch is suspected of having a problem, a flexible tube (a scope) can be placed inside to look around and diagnose the problem.