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Question about J-pouch?

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Posted 1/25/2014 5:56 AM (GMT 0)
This might sound like a dumb question....but can you have a j-pouch if you don't have a rectum? I still have my rectum and my ileostomy is reversible. However, my rectum contains some disease sooo my surgeon says I will probably have to have it removed eventually. Will that also remove my hopes of ever having a j-pouch?
Posted 1/25/2014 11:53 AM (GMT 0)
When you have the j pouch procedure the rectum is always removed. The j pouch is essentially your new rectum.
Posted 1/25/2014 4:09 PM (GMT 0)
AHHHH I must've had that confused, what become the "cuff" then Marianne? And how do you have any sensation or muscular movement back there to control anything?
Posted 1/25/2014 4:32 PM (GMT 0)
Just a small amount is left...about 2 cm so there is something to attach the pouch to. Your sphincter muscles are left in tact for control. Here below is a quick explanation of a two step procedure:



The first surgery removes the entire large bowel and the lining of the rectum, but leaves the rectal muscle intact. A reservoir or "pouch" is made out of small intestine and then is connected to the anus. Next, a temporary ileostomy is made. An ileostomy is a surgically created opening between the small bowel and the skin of the abdomen through which stool and gas are passed. This temporary ileostomy diverts the stool; protecting the reservoir (pouch)while it heals. (See figures 1, 2 and 3)



The second surgery (usually done 2-3 months after the first) "takes down" or removes the ileostomy and reconnects the bowel. The pouch now becomes functional so that waste passes into the pouch, where it is stored. When an "urge" is felt, the stool can be passed through the anus, out of the body.
Posted 1/25/2014 8:12 PM (GMT 0)
Thanks for the explanation. So what does the "urge" feel like? I can imagine it feels different than a colon but people say they have no problem holding their stool as long as they need to but at the same time "empty" numerous times a day. Is there a different feeling entirely? Does "urgency" feel the same?

Sorry to jack your thread OP
Posted 1/25/2014 8:43 PM (GMT 0)
The urge feels like pressure "down there". I can hold it for a long time and go when it's convenient for me. But the longer I hold it, the more of a pressure feeling I get. So yes, it's a different sensation than the urge to go with a healthy colon. It's not anything like a UC flare urge when you have to get to a bathroom NOW! Those days are gone thank goodness!
Posted 1/25/2014 9:04 PM (GMT 0)
Yes, it feels like pressure. Generally I'll feel a pang of pressure, I hold it, the pang goes away. The longer I wait to get to a bathroom the more frequent the "pangs" are and the pressure increases a little bit. It's almost hard to remember now but I think that with a colon there are more non-localized feelings to indicate needing to go, like I remember having abdominal cramps, chills, etc when I needed to go and that's completely gone.
Posted 1/25/2014 11:00 PM (GMT 0)
Oh ok, thanks again for the responses
Posted 1/27/2014 6:29 PM (GMT 0)
Yes, the sensation is really just a "oh I need to go." But it's not urgent. I liken it to being on a highway when you have to pee and seeing a sign that says the next rest stop is in 42 miles ... you might wish it were sooner and eventually, the pressure gets a bit uncomfortable, but it's bearable - and no more accidents!
Posted 1/27/2014 8:28 PM (GMT 0)

PSUDOC said...
Yes, the sensation is really just a "oh I need to go." But it's not urgent. I liken it to being on a highway when you have to pee and seeing a sign that says the next rest stop is in 42 miles ... you might wish it were sooner and eventually, the pressure gets a bit uncomfortable, but it's bearable - and no more accidents!

great analogy PSUDOC.....Describes it to a tee!
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