J Pouch Surgery Specialist

What is J-pouch surgery?

J-pouch surgery, or ileal pouch-anal anastomosis (IPAA), is the most common surgical procedure performed for managing ulcerative colitis (UC) and familial adenomatous polyposis (FAP) — an inherited disease characterized by cancer of the colon and rectum.

When you have J-pouch surgery, Dr. Zaghiyan removes your entire colon and rectum but preserves your anal canal. Then, she uses a portion of your small intestine to make a pouch-shaped like a J and connects it to your anus to preserve normal bowel function. 

How does J-pouch surgery work?

Dr. Zaghiyan performs J-pouch surgery in two or three stages, depending on your overall health and nutrition at the time.

Stage one

Dr. Zaghiyan removes your colon and leaves your rectum. Then, she creates a temporary surgical opening called an ileostomy to divert your stool. This step allows you to heal, come off your medications, and grow stronger.

Stage two

This step generally occurs three months later. At this point, Dr. Zaghiyan removes your rectum and makes the J-pouch from your small intestine. She sews or staples this new pouch to your anus and creates another ileostomy to divert your waste so your J-pouch can heal.

Stage three

The last stage of a J-pouch surgery is reversing your ileostomy.

For most men and women with ulcerative colitis and FAP, Dr. Zaghiyan can perform J-pouch surgery in two stages. In these cases, she performs the first two stages at one time and simply reverses your ileostomy two months later.

Whenever possible, Dr. Zaghiyan performs J-pouch surgery through a minimally invasive approach using laparoscopic and transanal techniques called transanal ileal pouch-anal anastomosis (taIPAA). 

This approach allows for minimal skin incisions with the majority of the surgery performed through the anus using endoscopic techniques. As a result, scarring is minimized and surgical recovery can be much more speedy.

Dr. Zaghiyan is one of the leading experts in this approach to J-pouch surgery with one of the largest experiences with this procedure in the world. 

What can I expect after J-pouch surgery?

Even though J-pouch surgery is a major procedure, most men and women begin seeing results quickly. At first, you will have many bowel movements a day, but you’ll have control over them and can make it to the bathroom in time. 

Additionally, the urgent need for a bowel movement that’s usually seen with ulcerative colitis also resolves immediately.

After several months, your J-pouch begins functioning more like a rectum, and your daily bowel movements reduce to between four and six occurrences.

Possible complications of J-pouch surgery include:

• Dehydration 
• Small bowel obstruction
• Inflammation of the J-pouch, or pouchitis
• Paralytic ileus, or irregular intestine function
• Anal stenosis

Some of these complications might require medical treatment, like medication, hospital admission, or intravenous (IV) hydration. Dr. Zaghiyan might also recommend surgical treatment for issues like anal stenosis.

Call Karen Zaghiyan MD or schedule an appointment online today to learn more about J-pouch surgery.