Jpouch

A Jpouch, short for J-shaped ileal pouch, is a surgical reconstruction used after removal of the colon and rectum to restore intestinal continuity. It is a form of ileal pouch-anal anastomosis (IPAA) in which a segment of the terminal ileum is fashioned into a J-shaped reservoir and connected to the anus. The goal is to allow storage and controlled evacuation of stool without a permanent external ostomy.

Indications for a Jpouch include ulcerative colitis or familial adenomatous polyposis requiring proctocolectomy, typically when the colon and rectum are removed but continence is desired. Suitability depends on factors such as rectal involvement, sphincter function, pelvic anatomy, and overall health.

Operative approach is often staged. The ileal pouch is constructed from distal ileum and shaped into a J, then connected to the anal canal via an pouch-anal anastomosis. A temporary diverting ileostomy is commonly placed to protect the new connection, with reversal planned after healing. Variants exist, including S- and W-pouches, though the J-shaped configuration remains common.

Outcomes commonly include preserved continence and improved quality of life after recovery, with stool frequency typically higher initially and gradually decreasing over time. Long-term function depends on pouch health, pelvic floor support, and adherence to follow-up.

Complications can include pouchitis (inflammation of the pouch), anastomotic leaks, pouch failure requiring revision or permanent diversion, stenosis, obstruction, dehydration, and changes in sexual function in some patients. Regular follow-up with a colorectal surgeon is advised to monitor function and manage complications.

See also: ileal pouch-anal anastomosis, restorative proctocolectomy.