Is it a big risk to have a jpouch reconnected if there is Crohn’s in it?
I have been diverted to a stoma for now due to Crohn’s of the pouch. My GI doctor said the goal is to reconnect it once everything heals. Wouldn’t the inflammation return after the reconnection?
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Excellent question!! Before I give you a good answer, I need some questions answered:
How bad is the Crohns in your j-pouch?
Are you currently taking medication for your Crohns now?
Where is the Crohns located in the pouch?
I had my pouch disconnected due to severe perianal inflammation. I also have a complex fistula coming from my jpouch and have a couple of setons in me to drain the fistulas. My GI doctor said he is almost certain it is Crohn’s disease of the pouch because I also had pouchitis symptoms. He said pouchitis plus fistulas is usually Crohn’s Disease. I am currently going for Infliximab infusions. He said the goal is to reconnect me to the jpouch by next summer. I said to him isn’t the jpouch only for ulcerative colitis? He said since I already have the pouch it can be reconnected if I completely heal, but he could not guarantee the that the inflammation would not return.
@AL77 posted:I had my pouch disconnected due to severe perianal inflammation. I also have a complex fistula coming from my jpouch and have a couple of setons in me to drain the fistulas. My GI doctor said he is almost certain it is Crohn’s disease of the pouch because I also had pouchitis symptoms. He said pouchitis plus fistulas is usually Crohn’s Disease. I am currently going for Infliximab infusions. He said the goal is to reconnect me to the jpouch by next summer. I said to him isn’t the jpouch only for ulcerative colitis? He said since I already have the pouch it can be reconnected if I completely heal, but he could not guarantee the that the inflammation would not return.
Okay thank-you for explaining fully. I also have Crohns disease.
I would recommend this: I do not think its a good idea to get your j-pouch connected, especially since you have perianal disease. I seen a video with someone that also has Crohns Disease and he had perianal disease- due to the perianal disease his doctor did not recommend him to get a j-pouch but to have a ileostomy like I have. Since you are already having issues and are currently taking biologics, I would strongly recommend a J-pouch removal and to have a permenent end ileostomy, that is what I would personally do. If you feel like you have to see this journey through with your J-pouch to not have regrets in the future so you can be able to say, I tried everything and gave it all I could, then I support that too. I think both choices will have consequences but only you can decide which is better for you. Whatever choice you decide, please do not keep an unused j-pouch inside you permanently, that is not a good idea at any situation.
I would suggest doing a pros and cons list of keeping J-pouch or getting rid of j-pouch, I think that strategy will help.
Let me know what you decide and let me know if you need help 
I know it is risky to reconnect. My doctor said the jpouch can be kept in disconnected because there is very little chance of cancer forming in it. So I can stay the way I am with a loop Ileostomy, reconnect to the jpouch, or do what you said, have the pouch removed and get a permanent end Ileostomy. I’ll see how it goes over the coming months.
@AL77 posted:I know it is risky to reconnect. My doctor said the jpouch can be kept in disconnected because there is very little chance of cancer forming in it. So I can stay the way I am with a loop Ileostomy, reconnect to the jpouch, or do what you said, have the pouch removed and get a permanent end Ileostomy. I’ll see how it goes over the coming months.
I would not trust that idea of keeping an unused j-pouch. That is definitely not a good idea. I would get the pouch taken out and get an end ileo.
And okay sounds good, let me know what you decide.
Okay, btw did you have a jpouch and had it removed? What surgery or surgeries did you go through?
