It is a difficult decision.
But only one you and your surgeon can make.
I had elective surgery...... Went with the Pouch..... Now I am going to the permanent ileosomy.  My pouch won't work.
My decision was made that way because I didn't want to regret not trying the Pouch. 
I don't.  But I am onto the next step.
Good luck to you.  I found that any decision is a good decision if you are facing this.  It's all personal.  And in the end it's to get your health back and stop the suffering.
Richard.

So hard to decide...Becky...how would you feel with a permanent ileo? If you are comfortable with the idea then why not? There is no 'better' or 'worse' situation there is only what you feel comfortable with...you can ask your surgeon to create the pouch if you like, stay with the ileo for a while (some people decide not to have the reversal  for ages) and see how you do...

Sharon

They can sometimes improve the clarity of the diagnosis by examining the whole colon. In my case they couldn't, though.

Thank-you for your reply's and being so supportive to others.  I feel so lucky to have this website to go to for advice.  

If you are going to have a 3-step procedure, you WILL have an end ileostomy and time to decide if you wish to stay with it before going on to step 2 and j-pouch formation. But, once the rectal stump is removed, you cannot go back and change your mind that you want the j-pouch after all.

 

Jan

As others have said and a friend here locally is doing, you can proceed with the 3 step jpouch surgery, the first step is I believe an end ileo. my friend has chosen to wait and see, perhaps punting the other surgeries until much later or if she decides she's okay with the end ileostomy might then decide to have the rectal stump removed. Personally I had a nineteen year run with occasional bouts of pouchitis but med free and for the past almost ten years have been battling to keep my jpouch although my dx has morphed to crohns with two strictures, one in the pouch and one above, as I say to others who debate, I would even knowing what I know today ie that my jpouch is threatened I would still choose exactly the same. But its what you decide, I have another friend who 2 years ago chose to have a perm ileo and not futz with a jpouch and another friend 5 years ago make the same decision. good luck on your journey whatever you decide.

 

It is a tough decision to make. I have, at times, wished I kept my ileostomy. I was getting used to managing it and developing a routine by the time I had the take down.

However, I have had equal positive results with the j-pouch. The issues I do occasionally have with the j-pouch, like occasional diarrhea and frequent bathroom visits, would have manifested themselves with the ileostomy. as well, just in a different way. I don't find one or the other more or less convenient. 

With the j-pouch patience is the ticket. I am just 2 years post take down and I think my small intestine is still learning how to behave more like a colon. I expect my situation to continue to improve.