j-pouch vs direct connect

i think frequency and burn would shoot through the roof with straight connect!!!

Law of physics would still favor a reservoir to slow down transit time and help with absorption of liquids (which would reduce burn to some degree). Straight connect seems like it would be very high acidity and burn on the anus!! And also, i think for "straight connect" some more rectum is preferred - which is contra-indicated for IBD patients. I think j-pouch is still considered better, even with pouchitis, because pouchitis is "usually" "easily" treated with antibiotics and overall has better function.

Frequency would be a nightmare. I would anticipate almost constant bms due to peristalsis (think of an end or loop ileo--that's what it would be like with no anal reservoir). The whole point of the j-pouch is to mimic, as much as is possible under the circumstances, the natural function of the rectum. As for a straight connect, honestly you would be better to have an ostomy.

If, on the other hand, you are thinking of a "pull through" where the colon is removed, but the rectum left intact and connected to the ileum, this generally only works if there is no involvement of the rectum. Needless to say, it's contraindicated for UC, since UC, far more often than not, does affect the rectum. That being said, a pull through is possibly an option for colon cancer when the rectum is not affected, severe diverticulitis, or for otherwise healthy individuals who have had a portion of their colon damaged from trauma. But it would not be a viable option for IBD suffers.

There is also a colonic j-pouch, created when it is necessary to remove the rectum, but an upper portion of the colon is still intact; again this is more so for cancer patients and not IBD.

are our j-pouchs hollowed out as one double wide small intestines or are they folded and sewn that way leaving a wall in between? hope that makes sense.

they are "hollowed out"; there isn't a wall in-between. like this: you have a 10 foot hose and make a vertical slice from one end of the hose just up to the 3 foot mark. you then take the sliced portion, fold it over back on itself and sew it, so it now is like a baggie. Or like this: you take your left sweater sleeve, slice it lengthwise from the elbow to the hand. Do the same thing on the right side. Now sew the left open part to the right open part. not sure if that even made any sense! but yeah - "hollowed" out!

it helps to see a diagram. even though there is a "line" down the center, that just shows where the 2 pieces were sewn together to make the "holding tank"

http://j-pouch.org/illustratedpouch/