J-Pouch Surgery: Pros vs. Cons

by Jackie Zimmerman Patient Advocate

If you've spent any time in inflammatory bowel disease (IBD) communities, chances are you've heard of a j-pouch. But you might still be wondering: "What exactly is a j-pouch and why does someone have one?"

What is a j-pouch?

A j-pouch is made from a piece of the small intestine after the large intestine and rectum have been removed. It is shaped like a "J," which is where it gets its name. There are other pouches that are similar to a j-pouch, but the most commonly used one is the j-pouch because it has had a high success rate.

Why does someone get a j-pouch?

If you're wondering why a person gets a j-pouch, well, there are a number of reasons. In my case, I received a j-pouch after a severe case of ulcerative colitis. People with Crohn's disease are less likely to get a j-pouch because Crohn's can run through the entire digestive tract, so it is more difficult to remove the diseased parts of the digestive system. You will hear of people with j-pouches who have Crohn's, but it's not as common as for ulcerative colitis patients.

Pros vs. cons

My experience with a j-pouch has been very positive. I am very fortunate in that I currently have no eating restrictions or requirements. I am able to maintain my weight without issue (which is an issue of its own). I rarely have any pain or nausea, and I have been relatively colitis-free for almost four years now. I am able to control when I go to the bathroom and am able to hold it for more than eight hours if I need to. I recently took a hiking trip and did not need to worry about being in the desert all day sans toilet. In short, I have been freed from pain and being tied to a bathroom. So far, my j-pouch is a total rock star.

However, it is important to remember that removing your colon is no small matter and it does bring some changes, as removing any organ would. For me, the biggest downside to living with a j-pouch is pouchitis. Pouchitis is when your j-pouch gets inflamed and you feel much like you did when you were living with UC. There can be fevers, pain, blood in the stool, straining, nausea and other symptoms as well. The good thing about pouchitis is that, for most people, a course of antibiotics can take care of it within a few days.

As for additional cons of living with a j-pouch, I do have friends who still have eating restrictions, so they avoid fruits, veggies, nuts, seeds and meats with casings. Others still live with pain and bleeding in their stool on a regular basis.

A j-pouch is certainly not perfect; I always say that it's like trading one large set of problems for a smaller, more manageable set of problems. That said, I have been very happy with my j-pouch overall, and would take this option over my diseased colon any day. It should be noted that the opinions stated in this article are solely based on my personal experience and don't apply to everyone. In truth, living with a j-pouch is often like living with IBD: It is a different experience for everyone.

Jackie Zimmerman
Meet Our Writer
Jackie Zimmerman

Jackie Zimmerman is a multiple sclerosis and ulcerative colitis patient and the founder of Girls With Guts. Since diagnosis, she has blogged her IBD journey at Blood, Poop, and Tears. Jackie has worked hard to become a strong voice in the patient advocacy community. In her free time (what free time?!) she spends time with her two rescue pups, her husband Adam and plays roller derby. She’s online @JackieZimm.