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Pros and Cons of J Pouch Surgery

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If you have had a severe ulcerative colitis inflammation and the medicine hasn’t been helping you, then your doctor may have recommended J-pouch. J-pouch is a surgical procedure to construct an internal reservoir by removing the colon and the rectum. Scheduled for J pouch surgery? Look at the following pros and cons of the surgery to understand more about it and remember everyone has a different experience in living with the j-pouch.



1. Control bowel movement: After the surgery, you can be able to control when to go to the bathroom and also be able to hold up as many hours as you need.

2. Maintain weight: You will be able to maintain weight gain without any issue which was a difficult thing to do before the j pouch surgery.

3. Better quality of life: Before the pouch, many people are always very sick and have to use the bathroom several times. The pouch has made them happy, have a quality life and do whatever they want. No more going to the bathroom 4 to 8 times a day.

4. Eliminates nausea: You no longer feel nausea or some pains since you live colitis-free.

5. No eating restrictions: A successful surgery results in a positive experience. You will not have any eating restrictions or requirements. You can eat anything you want.

6. No more drugs: You don’t have to keep on taking medication to control your condition. After the surgery, no more medication is needed unless when fighting pouchitis which can be solved with a few antibiotics.

7. No need for an ostomy bag: The primary reason why most people go for a j-pouch is to do away with the ostomy bag. No need to pay more for ostomy supplies.

8. Enjoy more outdoor activities: You don’t have to bother more with appliance maintenance and ultra-hygiene associated with the use of ostomy bags. This makes you enjoy your outdoor activities more without having any mushy bag taped to you 24/7.



1. Pouch failure: Although it’s very rare, any failure of the pouch results in its removal and return to using ostomy.

2. Small bowel obstruction: A small percentage of pouch surgery patients can experience bowel obstruction conditions.

3. Cause Pouchitis: When j-pouch gets inflamed, you may feel some pain, blood in the stool, straining, and a high fever. Although this can be solved using antibiotics.

4. Pain and bleeding: There are people with j-pouch who still experience some pains and bleeding when passing stool on regular basis.

5. Create other problems: Although the j-pouch is healthy and great, there are people who have other complications like gallbladder issues, fistulas, and adhesions that could be caused by the surgery.

6. Incontinence: Immediately after the surgery, there may be j-pouch leakage or incontinence although this can go away with time. Some of the pouches may have an occasional leak from time to time forcing you to wear diapers. This can be humiliating at times.

7. Loose bowel: Removing the colon results in having loose bowel movements compared to normal people and sometimes this liquid form of bowels can cause a burning sensation in your anus.

8. Not for everyone: Crohn’s patients should not go for pouch surgery since the chances of their disease affecting j-pouch are very high. Patients with a perianal disease have high chances of failure of internal j-pouch surgery.

9. Cause Sepsis: J-pouch may lead to sepsis infection into the bloodstream causing some organ failure.

10. Depend on undergarment is not enough: When j-pouch leaks, depend on undergarment/diaper is not enough especially when sleeping.

This Post Has 3 Comments

  1. Rajeev Bhargava

    Dear Dr Eric Jonson, I’m on a waiting list for J-Pouch Surgery for my chronic Ulcerative Colitis and I’ve been advised by my main hospital consultant it is the right step. I had my Sub-Total Colectomy with end Ileostomy last year on 27th May 2021. Now, I am due for an abdominal MRI to check if there are any symptoms-signs of Chrons disease, on 16th July 2022. After this, an appointment with my Pouch Nurse and then the surgery. I must confess, I am absolutely PETRIFIED. I am scared out of my wits. It is all about being cut open after all. I am also on Prednisonal Steroid Suppositries but still getting lots of regular bleeding caused by a wild flare up. There is also the scare that it will ultimately turn to bowel cancer. Should I go ahead with J-Pouch or wait. It’s not so much about living with a stoma bag, as I have adapted: it’s about bowel cancer down the road. Please can you guide me on whether to get surgery or not, under my circumstances. I’ve had UC diagnosed since October 1988. Thanks alot. Rajeev.

  2. B

    Terrible article very inaccurate. Please don’t follow this. Full of ads.

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