Rectal Cancer, Ulcerative Colitis and the J Pouch

Medically reviewed by: Gary H. Hoffman, MD

What Does A J Pouch Have To Do With Rectal Cancer or Ulcerative Colitis?

The mere mention of rectal cancer or ulcerative colitis (U.C.) sends fear through most people.  And this is understandable.  These diseases, even when cured, come at a high cost to physical and emotional well being.  But, with our innate desire to live happily, these illnesses represent a real threat.  The colon and rectal surgeon (also known as a proctologist), using the facilities and nursing support staff of  your Los Angeles hospital, such as Cedars-Sinai Medical Center, can help.

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What does the letter “J” have to do with all of this?

Operative Treatment For Cure.  “J” is important.  So Is IPAA.

The goal in treating ulcerative colitis when medical therapy has failed, is to remove the entire colon and rectum.  This usually stops the disease, but leaves the patient without a rectum.  Simply connecting the ileum (the end of the small intestine) to the anal canal is fraught with difficulty with bowel control.

The goal in treating rectal cancer, especially a rectal cancer close to the anal canal, is to remove the portion of the rectum harboring the cancer and reconnect the remaining colon to the anal canal.  Again, simply reconnecting the colon to the anus can likewise cause difficulties with continence.

In both of these operations, the J pouch can help.

J pouch.  What Is It?

You needn’t be a rocket scientist to understand that by taking the end of a piece of colon or small intestine and folding it back upon itself, will look like the letter “J” when viewed from the side.  Furthermore, connecting the two, folded, separate pieces of bowel together in the middle of the “J”, crates a pouch, or a new rectum (the neorectum).  The neorectum is a pouch which recreates the capacity of the natural rectum.

In the case of the small bowel pouch, the end of the ileum is fashioned into the pouch, the so called IPAA, or ileopouch-anal anastomosis.  In the case of the colon, the remaining end of the colon is folded back to form a colonic J pouch.  Different pieces of intestine with the same idea; to hold the fecal material until it can be voluntary discharged.

Do They Work?

Yes, but with a caveat.  The new pouch, although effective, can be associated with more than normal numbers of bowel movements per day or night.  Also, occasionally, sexual functioning can be compromised.  Additionally, the pouch can become infected.  But overall, the pouch can help patients avoid having to have an ileostomy or colostomy (whereby the bowels empty into a bag on the side of the patient’s abdominal wall).

Los Angeles Colon and Rectal Surgical Associates.

The colonic J pouch and the IPAA are advanced techniques and concepts.  Your board certified surgeons of Los Angeles Colon and Rectal Surgical Associates are experienced and trained in the use of these pouches, and in diagnosing and treating all diseases of the colon, rectum and anus.  Should you need a pouch, your surgeons will provide you with the expertise and information to help you understand all of this.

Call (310)273-2310 to schedule a confidential consultation and learn about your illness, its treatment and long term effects.

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