This topic is about someone who is considering whether to remove their J-pouch after experiencing severe complications. Here's a bit of background and some advice that might be helpful:

- The person was diagnosed with Ulcerative Colitis in 2014 and initially managed it with prednisone and Asacol.
- In mid-2015, the condition worsened, leading to Remicade infusions, which eventually stopped being effective.
- By May 2016, an urgent total colectomy and end ileostomy were performed. The recovery was quick, with a return to work in 8 weeks and only one brief hospital readmission in early 2017 for a stomach ulcer.
- In July 2017, a J-pouch was constructed. Since then, the person has faced ongoing health issues, including frequent hospitalizations due to epigastric pain, nausea, and vomiting. Earlier hospital stays were attributed to "gastritis," but the most recent one lasted over two months without a clear diagnosis.
- The individual has lost more than 25% of their body weight and is severely malnourished, requiring a month of TPN via a PIC line.
- Due to these complications, they are uncertain whether to proceed with the final takedown surgery or have the J-pouch removed entirely.

The person has had a candid discussion with their trusted surgeon, who recommends proceeding with the reconstruction once their weight stabilizes, which is expected to happen within two weeks. They are seeking first-hand experiences, insights, and tips on what to expect after the reconstruction or takedown.

Here are some pieces of advice and insights:

1. The J-pouch itself might not be the main issue. It's important to get a thorough explanation from the surgical team about:
- What exactly is wrong at the moment,
- All realistic treatment or surgical options, including the pros and cons of pouch removal versus completion,
- The probable outcomes, risks, and benefits of each option.

2. Consider getting a second opinion from another surgeon to ensure that no issues or alternatives have been overlooked.

3. Having a surgeon who communicates openly and treats patients as individuals, rather than just "cases," can make the decision-making process easier and more reassuring.