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This Type Of Surgery Is Only Done For People With Ulcerative Colitis


Updated July 09, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Definition: A j-pouch is an internal pouch to hold stool that is created from the last part of the small intestine (ileum) and attached to the anus or the remainder of the rectum. The terminal ileum is sewn back onto itself to form the shape of the letter "J."

J-pouch surgery is most often done to treat ulcerative colitis, but may also be done for a condition called familial polyposis. The advantage of j-pouch surgery is allowing patients to eliminate stool through the anus, obviating the need for an ostomy pouch that is worn on the side of the abdomen to collect waste.

The procedure is a series of surgeries that may be done in one, two, or three parts. During the surgeries, the large intestine and part or all of the rectum is removed, and the j-pouch is created.

The time between surgeries depends on several factors, including the patient's overall condition before the surgery and the pace of recovery.

In the two- or three-part procedure, a loop ileostomy is created in order to let the intestine and the j-pouch heal between surgeries. While the ileostomy is in place, waste is collected in a bag that is worn on the side of the body. During the final surgery, the loop ileostomy is closed. Stool then passes through the j-pouch, allowing the patient to eliminate through the anus.

In some cases, the ileum is sewn into a different shape, such as an "S" or a "W," although these are less common than the "J." The shape of the pouch created is decided on by the surgeon.

Also Known As: ileo-anal pouch, s-pouch, w-pouch, ileal-anal pullthrough, internal pouch

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