whats the truth about jpouch surgery?

You're unlikely to ever have a formed stool again, but when you don't have a colon it doesn't really *matter* if your stool is formed. With UC you want formed stool because it's a sign of remission -- when you don't have a colon, you can be 100% healthy and not have formed stool. It might be a little messier, but that's about it. I was so sick and had tried virtually all of the available UC meds, so when I opted for surgery I didn't think I would ever have a formed stool again, whether I had surgery or not.

Your ability to conceive naturally can decline after any kind of abdominal surgery, j-pouch included. If a pregnancy is something you want to do in the near future, you should share that with your surgeon.

My takedown was 12 days ago and my life so far has been like this:
I have a bowel movement about every four hours. Sometimes I go longer in between (especially if I'm in a deep sleep, I've gone like 8 hours overnight a couple of times), sometimes less (usually in the evenings I go more frequently). For the past week I have consistently had 5-6 BMs per day. I have uncomfortable pressure in my rectum (or where the rectum used to be...) and "spasms" like strong urges every so often, but I'm told this will decrease with time and eventually go away completely. I am 99% continent -- on a couple of occasions I have passed gas while sleeping and a small amount of liquid came out with it -- this is expected to decrease or go away completely with time.

So that's the aftermath for me thus far. I can say that categorically post-op life has been way better for me than life with UC -- even just a few days out from surgery I was able to go out in my car, run errands, go to the movies, etc, things that I never dreamed of doing when I was sick with UC and 100% incontinent (literally in diapers... I had about 10 seconds to make it to a toilet). I have discomfort from "training" my new j-pouch and having urges to go to the bathroom, but I don't have frank *pain* like I suffered every day with my colon. I would say that at this point, my quality of life with an ileostomy was better than my quality of life right now. BUT I expect my QOL to improve a lot in the upcoming weeks and months and that eventually it will surpass how I felt with the ileostomy.

I think you just need to do a lot of research... You'll hear from the same handful of j-pouchers who hang around this board but we do not in any way run the gamut of potential j-pouch experiences.

For my two cents, I do NOT believe that surgery is a cure for UC. Your body still has an underlying tendency/defect/whatever, it just doesn't have the organ there to try to destroy anymore. I do think that surgery is the most effective treatment we have for UC.

I have a permanent ileo, the bag. So I can't speak to after the jpouch. I just want to tell you not to let the possiblilty of a failed jpouch or a permanent bag stop you from surgery. Life is so much better and I am very happy. I chose this over a jpouch.
Surgery is very scary and very hard, it's not fun. But it's worth it.

Having a j pouch is adjusting to a new normal. You will go to the bathroom more frequently but you are not sick anymore so there is no pain, cramps or urgency. In the early weeks/months after the final takedown surgery it can be a bit crazy as your body heals and adjusts to its new plumbing but it all settles down and you get on with life UC free. I don't consider it a cure either because it's major surgery removing a major organ but it's an extremely effective treatment for someone with severe UC who cannot get it under control with meds. My j pouch has given me my life back that UC took away.

Every single surgery experience is a little different so, we can't really predict what things will be like for you. I can share a little bit of my own journey though.

For me, surgery was hard. Really hard. It was an incredibly difficult year emotionally, physically....just everything. I sometimes refer to it as my walk through hell but, I regret nothing.

I had takedown in January 2012. I did have some frequency and dehydration issues in the first weeks after that. Now though, everything is working well. I am a full time nursing student, I chase after two young active boys, and I am a distance runner training for a marathon and none of those things has to revolve around where the nearest bathroom is anymore.

As to the formed poop issue....it varies for everyone. Heck, it is even varied for me depending on what kind of food I've been eating and how much I've had to drink. Even when it isn't though....it doesn't matter. When I feel like I need to go, it's more like before I had UC. Kind of "Well, I'm going to have to go to the bathroom here in a bit." Not urgent, not painful, not drop what I'm doing to run for it and hope I make it in time. I've had really good results and not had any incontinence at all, even right after surgery. That does vary from person to person though. Also, I got a bidet seat for my toilet so I almost never have burn or skin issues. If we go on vacation and I'm away from my "fancy toilet" (as we like to call it, lol) I will get some irritation but nothing too awful and it clears up within a day or so of being back home and using the bidet again.

The fertility question is a delicate and tricky one. I already had two children so it wasn't as urgent a concern in my situation. I was considering a third child after surgery. I discussed it with my surgeon and he was honest with me about the risks. Anytime you open up the abdomen and move things around, etc you're creating scar tissue and other things that make it harder to conceive. I talked to my OB/Gyn and she said she would be comfortable helping me if we worked with a high risk OB and I agreed to a c-section. Again, this is something that will differ for everyone. Have an honest conversation with your surgeon and OB and see how you feel after.

It is a really difficult decision. Everyone around me thought I was crazy for opting for surgery. Now though, they readily agree I did the right thing. I hope you find peace and good health with whichever direction you chose.