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process for reconection and J pouch

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Posted 7/30/2009 10:12 PM (GMT 0)
Husband has an ileostomy with the provison for j pouch (I think that is what it is called) if he chooses. What is the process to have that done? Is there one or two more surgeries? He is really undecided, he has had such a rough time so far with complications he doesnt know if he should mess with any more stuff. He is a young 58year old, was very active. Right now though his core muscles are cut and he has a surgery wound that looks like a shark attack so he is thinking he will need to get his belly fixed and wondering about the pouch.

infor would help

thanks
Posted 7/31/2009 1:04 AM (GMT 0)

I assume your husband has a loop ileostomy now?  If that's the case then he still has his anus and a portion of his rectum left.  There are two options.  One, he can wait a year or more to complete the jpouch surgery (one more surgery most likely) or two, he can wait and have a permament ileostomy (removal of the rectal cuff and anus) at his convenience.  Either way he will have to have more surgery but with either choice there's no rush.  Many people wait to return to better health.

Sue

Posted 7/31/2009 1:14 AM (GMT 0)
thank you for your reply. Now you have me thinking, he might very well have the loop already because his surgeon specifically said she had made it possible for him to have j pouch reversal. We will have to ask more questions. If he has the loop as you suggest does that mean they have already formed to pouch and the next step is removal of the rectum and takedown?
Posted 7/31/2009 1:50 AM (GMT 0)

There's one of two scenarios:

1.  He has a loop ileostomy and has his jpouch made but non-functioning.  If this is the case the second surgery is quite simple, close the ileostomy and the pouch starts working.

2.  He has a loop ileo and had most but not all of his rectum removed, but the pouch is not made yet.  If this is the case the second surgery is a bit more complicated.

Best to find out from his surgeon where he exactly stands.

Sue

Posted 7/31/2009 2:04 AM (GMT 0)
thank you. Based on your explanation I believe it is number 2. The loop is there but the pouch not yet formed. the surgeon said he would go to another major hospital nearby where there are 2 doctors that do all this work. That has got to mean the pouch etc. So if I understand her part of it was to do the loop ileostomy. How is that different from a regular ? ileostomy?
Posted 7/31/2009 3:15 AM (GMT 0)

A loop ileostomy is intended to be temporary so they are typically harder to manage.  Picture a garden hose cut halfway through with one part sticking out of the abdomen (the ostomy) and the other part (not functioning) but hanging in the abdomen.  Because a loop ostomy is not flush with the abdomen there can be more skin problems.   Also they are higher up on the waist line than a permanent ostomy which means transit time is quicker and stool is looser.

Sue

Posted 7/31/2009 2:09 PM (GMT 0)
One thing that may help you to better understand how everything is done is to visit j-pouch.org. They have a link called "illustrated pouch" that discribes the process and provides, well, illustrations. It wasn't until I looked at this that I really grasped what had been done during my first surgery and what I still had to come. The process it shows is for having the pouch made at the time of the colectomy, but even if your husband has yet to have his pouch made, I think it would still help you get a better idea of how the pouch is formed and what the reversal entails.
Posted 3/15/2011 11:55 AM (GMT 0)
has anyone had a j pouch and if so how has that been working for you? I had my ileostomy takedown almost a year ago and i still visit the bathroom at least 10 times a day. I am fighting having a permanant colostomy bag put on but the dr said he could try a j pouch but there was no guarantees. help i want to go back to work but cant the way i am , any advice welcomed . thankyou vetman

Posted 3/15/2011 1:09 PM (GMT 0)
I've had a jpouch for 10 years; it's been awesome. I'm not sure I understand your question. Do you currently have an ostomy or ajpouch?

Sue
Posted 3/15/2011 2:54 PM (GMT 0)
Roliie.....When Dillon had his colectomy he was given an END ileostomy. The rectum was left, but closed at the top. We were told it was left in order to keep the anal tissue healthy. Being an end ileostomy, it was very easy to deal with and he could wait as long as he wanted before heading toward a J pouch. His second surgery was building the J pouch. If all had gone 100% by the books and his tissues were healthy they would have closed the ileostomy site and allowed the pouch to start working right away (he would have been in the hospital for a couple of weeks, while they kept an anal tube in to allow the pouch to heal). Unfortunately surgery did not go that smoothly and he was given a LOOP ileostomy for 8 weeks while the pouch healed. He then had a third operation which was the closing of the ileostomy site.

The take home message is that different surgeons do this differently. The best thing you can do is sit down with your doctor with all your questions.
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