Ileoanal anastomosis surgery (commonly called J pouch) allows you to eliminate waste normally after removal of the upper and lowest parts of the large intestine (colon and rectum). J-pouch surgery avoids the need for a permanent opening in the abdomen (stoma) for passing bowel movements.

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Ileoanal anastomosis is most often used to treat chronic ulcerative colitis and inherited conditions such as familial adenomatous polyposis that carry a high risk of colon cancer. Ileoanal anastomosis is also sometimes used to treat colon cancer and rectal cancer.

During the procedure, the surgeon removes the entire colon and rectum, while preserving the muscles (sphincter) and opening (anus) at the end of the large bowel. A pouch shaped like the letter J is constructed from the end of the small intestine and attached to the anus. An opening is constructed in the abdomen (ileostomy) for eliminating waste. The opening is temporary, to allow time for the pouch to heal. A few months later, a second operation removes the ileostomy. After that, you can pass bowel movements through the anus, with only slight increases in bowel movement frequency.

At Mayo, more than 75 percent of J-pouch procedures are done using minimally invasive surgery, which usually results in smaller incisions and a shorter hospital stay than conventional surgery. Surgeons at Mayo Clinic were also among the first to introduce completely laparoscopic and single-incision J-pouch procedures.

Most people can resume their normal activities, including work and sports, after J-pouch surgery. The surgery doesn't affect a woman's ability to have a normal pregnancy and delivery. But J-pouch surgery affects fertility, so Mayo Clinic experts will discuss the options with prospective parents.

The most common complication of ileoanal anastomosis is pouchitis, an inflammation of the newly constructed pouch lining. Pouchitis can cause symptoms similar to those of ulcerative colitis, including diarrhea, abdominal and joint pain, fever, and dehydration. The risk of pouchitis increases the longer the J pouch is in place, and also if you smoke or have inflammatory joint disease or certain skin diseases.

In most cases, pouchitis can be treated with antibiotics. When pouchitis doesn't respond to treatment, the pouch may be removed and an ileostomy constructed.

  • Advanced techniques. Mayo Clinic surgeons use a minimally invasive approach for most J-pouch surgery, which usually means smaller incisions and faster recovery than traditional open surgery.
  • Positive results. At Mayo Clinic, more than 90 percent of J-pouch surgeries have a successful outcome.
  • Follow-up care. Mayo specialists work together to control pain and prevent complications after your surgery.
  • Research leader. Mayo specialists are at the forefront of new techniques and procedures to ensure surgical success and prevent infection. You have access to the expertise of Mayo's clinician-researchers.

Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked high performing for digestive disorders by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for digestive disorders.

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Specialists in colon and rectal surgery perform ileoanal anastomosis surgery.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in colon and rectal surgery perform ileoanal anastomosis surgery.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in colon and rectal surgery perform ileoanal anastomosis surgery.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic researchers are working to improve treatment with ileoanal anastomosis surgery. Studies cover a wide range of areas, including hand-assisted laparoscopic techniques that can shorten the procedure, prevention and treatment of pouchitis, the feasibility of reconstructing a failing J pouch, J-pouch surgery's effectiveness for treating primary sclerosing cholangitis, and quality of life after J-pouch surgery.

Publications

See a list of publications by Mayo Clinic doctors on ileoanal anastomosis surgery on PubMed, a service of the National Library of Medicine.

Mar. 16, 2012