Healthcare: Gastroenterology & Digestive Health

J-Pouch (Proctocolectomy)

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What is a proctocolectomy?

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During a proctocolectomy, the large intestine and rectum are removed, leaving the lower end of the small intestine (the ileum). The doctor sews the anus closed and makes a small opening called a stoma in the skin of the lower abdomen. The surgical procedure to create the stoma (or any other artificial opening) is called an ostomy.

The ileum is connected to the stoma, creating an opening to the outside of the body. The surgery that creates the opening to the intestine is called an ileostomy.

Stool empties into a small plastic pouch called an ostomy bag that is applied to the skin around the stoma.

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What is a proctocolectomy?

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Scott Holmes
The J-pouch is sewn or stapled to the anus using a circular stapler. Illustration by Scott Holmes
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During a proctocolectomy, the large intestine and rectum are removed, leaving the lower end of the small intestine (the ileum). The doctor sews the anus closed and makes a small opening called a stoma in the skin of the lower abdomen. The surgical procedure to create the stoma (or any other artificial opening) is called an ostomy.

The ileum is connected to the stoma, creating an opening to the outside of the body. The surgery that creates the opening to the intestine is called an ileostomy.

Stool empties into a small plastic pouch called an ostomy bag that is applied to the skin around the stoma.

Part of your intestine was removed or separated from the rest of the intestine. This is most often done because of a disease. During the ileostomy, the surgeon made a hole in your belly and connected part of the small intestine to that opening in the skin. This opening is called the stoma.

A pouch is attached to the outside of the stoma. Stool collects in the pouch and must be removed several times each day. The stool will be looser or have more liquid than before surgery.

You are likely to have cramps that come and go for the next few days. You may also feel like you have the flu, and you may have a low fever and feel tired and nauseated. This is common. You will probably feel better in a week. A nurse or other health professional will show you how to care for your stoma and pouch after you go home.

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Why is a proctocolectomy and ileostomy done?

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Several situations may require surgery for ulcerative colitis or surgery for Crohn's disease, such as when medicines fail to manage your symptoms or when holes develop in the large intestine.

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How well does a proctocolectomy and ileostomy work?

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This surgery cures ulcerative colitis. About 7 to 8 out of 10 people have long-term success with this surgery.

Surgery will not cure Crohn's disease. But it may give people some time without symptoms. Crohn's disease usually comes back after surgery.

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