Jpouch with Rectum

Do you know if your surgeon actually constructed a J-pouch? Before J-pouches became the standard, a procedure called an "ileorectal anastamosis" (IRA) was generally considered the best alternative to an external ileostomy. This leaves the last part of the colon (the rectum) in place, and attaches the end of the small intestine to it. It's a simpler procedure than a J-pouch, is typically done in one step, and in some studies gets comparable (or even better) results than J-pouches. The major disadvantage is that it leaves a fair amount of colon behind, which (depending on the disease) can become inflamed, ulcerated, or cancerous. 

If your surgeon performed an IRA, this may have been a very reasonable choice, but you do have to monitor the remaining rectum regularly. If your surgeon performed a non-standard J-pouch procedure then he is an idiot, but you will probably do just fine anyway, as long as you keep an eye on that 10 cm of rectum. Your 5-7 BMs per day is comparable to a successful (standard) J-pouch or a successful IRA.

I'm curious, I've often thought of have liked my surgeon to leave a bit of rectum in, can you feel what is gas and what isn't? Can you pass has standing or sitting?  As Scott said you can leave the rectum of it's not diseased but it needs monitoring so many don't bother.  

Your frequency you may be able to tame with fibre and immodium and or diet, just tusk and error.

I was under the impression that they leave a part of the rectum. Or else how could we get cuffitis?

cuffitis is inflammation of the cuff not the rectum.   Think of a shirt arm v shirt cuff...technically its all bowel (or sleeve), medicine (or tailors) just labels parts differently.

They like to remove as much colon as possible, as less risk of cancer and other stuff. thats easier on skinny people (like me) than over weights.  So my j pouch connects almost direct to my anus, the amount of cuff or rectum is really minimal.  on larger people its harder to get in as close...

Scott F posted:

Do you know if your surgeon actually constructed a J-pouch? Before J-pouches became the standard, a procedure called an "ileorectal anastamosis" (IRA) was generally considered the best alternative to an external ileostomy. This leaves the last part of the colon (the rectum) in place, and attaches the end of the small intestine to it. It's a simpler procedure than a J-pouch, is typically done in one step, and in some studies gets comparable (or even better) results than J-pouches. The major disadvantage is that it leaves a fair amount of colon behind, which (depending on the disease) can become inflamed, ulcerated, or cancerous. 

If your surgeon performed an IRA, this may have been a very reasonable choice, but you do have to monitor the remaining rectum regularly. If your surgeon performed a non-standard J-pouch procedure then he is an idiot, but you will probably do just fine anyway, as long as you keep an eye on that 10 cm of rectum. Your 5-7 BMs per day is comparable to a successful (standard) J-pouch or a successful IRA.

Thanks Scott im going to have to look into that... i think he did meantion that it was something new he been doing for years...i will check into that tho...thanks for the info...

There's generally 1-2 cm of rectum left (the "rectal cuff") in a stapled procedure. That is indeed where cuffitis can develop. Most of us are connected up with staples, which is the most reliable procedure. In a properly done hand-sewn procedure there is little to no rectum left, and the ileum is sewn more-or-less to the innermost part of the anal canal.

Bobish posted:

I'm curious, I've often thought of have liked my surgeon to leave a bit of rectum in, can you feel what is gas and what isn't? Can you pass has standing or sitting?  As Scott said you can leave the rectum of it's not diseased but it needs monitoring so many don't bother.  

 

Your frequency you may be able to tame with fibre and immodium and or diet, just tusk and error.

No i cant tell....i just go to the restroom everytime i get the urge..sometimes if im in bed i can pass the gas tho....its very beneficial to have the rectum because i can go hours of holding my poop...i was told that i had a 5mm spot that was still colitis on my rectum but it doesn't bother me at all an im not on any medications for it.... the only thing i take is the imodium one pill a day