Question: What should I know about J-pouch excision and conversion to a permanent ileostomy?
Answer: The forum discussions provide several insights and advice for individuals considering J-pouch excision and conversion to a permanent ileostomy:
- Stoma Creation and Positioning: It is recommended to have the stoma placed away from belt or pants lines and to ensure it protrudes at least 1 inch to help with appliance sealing and prevent skin irritation. An enterostomal nurse should mark the optimal site pre-operatively and be available for post-operative care.
- Surgical Details: Clarify with the surgeon whether the operation will be open, laparoscopic, or robotic, and discuss the extent of diseased intestine removal. Understanding the follow-up schedule and trusting the surgeon is crucial.
- Managing Crohn’s Disease: Discuss long-term control options with a gastroenterologist, including biologics or newer medications, to prevent further small-bowel disease.
- Hospital Stay and Recovery: Typical hospital stays for this procedure range from one week to 10 days. Recovery experiences vary, with some individuals reporting faster output and better energy post-surgery.
- Practical Preparation: Bring entertainment to the hospital, have a support person for appointments and initial recovery, and maintain good rapport with nursing staff.
- Emotional Support: Nervousness is normal, but the surgery may offer relief from frequent doctor visits and medications. Community support is available, and sharing progress can help others.
- Pain and Recovery: Expect significant pain initially, with a strict pain-medication schedule recommended. Mobility may be slow, and full ease in sitting can take several months.
- Scar Tissue Considerations: Extensive prior surgeries can create adhesions that may complicate pouch removal. Pre-operative imaging and surgical strategy discussions are advised.
- Outcomes and Alternatives: Some members report that removal of the J-pouch solved or prevented serious complications. Non-surgical management options, such as output-thickening gels, may be considered if removal is risky.
Overall, thorough discussion with healthcare providers about risks, benefits, and management options is essential for making informed decisions about J-pouch excision.
Check out these links for more information:
- Facing J Pouch Removal and Permanent Ileostomy (September 13, 2024)
- Seeking Advice on Removing an Unhooked J Pouch (February 11, 2021)
- Heading in to surgery (September 11, 2014)
- Living with J-Pouch and Considering Permanent Ileostomy (May 06, 2009)
- Reconsidering My J-Pouch (March 09, 2024)
- J Pouch Issues After Ileostomy - Leakage and Pain (August 18, 2024)
- Should I Remove My J Pouch After Complications? (May 27, 2018)
- The surgery from hell (October 01, 2014)
- Perianal Crohn's Disease and Ileostomy Experiences (November 23, 2024)
- Experiences with the K Pouch vs. J Pouch (August 23, 2025)
