J-Pouch (also known as Ileal Pouch Anal Anastomosis (IPAA)): an internal pouch (J, S, or W-shaped) that is fashioned out of the small intestine upon proctocolectomy, allowing the patient to defecate via the anus and avoid an ostomy permanently.
J-Pouch/IPAA surgery is rarely done in Crohn’s patients as disease can present in the j-pouch. However, IPAA may be an option should the patient not want an ostomy. The patient may also need to be optimized on medication (usually biologics) if j-pouch/IPAA surgery is done in Crohn’s. It is always best for the Crohn’s patient to discuss with his/her gastroenterologist and surgeon as to the route offering the best prognosis.
J-Pouch surgery is commonly done in cases of refractory ulcerative colitis where there is no disease in the small intestine.
J-Pouch surgery may be done in cases of colorectal cancer, dysplasia, severe pancolitis, toxic megacolon and/or a bowel perforation which may lead to an ostomy temporarily.