This topic is about someone who has been living with an ileostomy for ten years and is now considering a total colectomy with a J-Pouch. This procedure involves reconnecting the small bowel to the anus, and the person is looking for advice and experiences from others who have gone through it. Here are some helpful insights and tips:

1. Make sure your surgeon plans to create a J-Pouch, which is an ileo-anal pouch, instead of a straight ileo-rectal connection. The J-Pouch can significantly improve bowel function and continence.

2. Be prepared for some initial incontinence after the surgery. It might be a good idea to wear diapers until you gain better control.

3. The number of bowel movements can vary after the operation. Initially, you might have around 15 per day, but this could decrease to 3–5 as your body adapts. However, some people might experience ongoing inflammation at the junction of the pouch and rectum.

4. Frequent bowel movements can cause the skin around the anus to become raw due to the enzyme-rich output. To protect and treat this area, use Calmoseptine ointment and clean gently with unscented baby wipes until your skin settles down.

5. In the worst-case scenario, you might need to return to an ileostomy. However, many people find a good quality of life somewhere between these two outcomes.