What is IPAA (J-Pouch Surgery)?

Ileal Pouch-Anal Anastomosis (IPAA), commonly called J-pouch or S-pouch surgery, is the gold standard operation for ulcerative colitis requiring surgery. The entire colon and rectum are removed, eliminating the disease. A reservoir (pouch) is fashioned from the last 30–40 cm of the ileum (small intestine) and joined to the anal canal. This restores near-normal bowel evacuation without any external bag.

Dr. Ashok Kumar has special expertise in pouch surgery developed during his long surgical career at SGPGI. He is one of the most experienced pouch surgeons in Lucknow and Uttar Pradesh.

Staged Approach

• 2-Stage IPAA (Standard) — Stage 1: proctocolectomy + pouch creation + temporary loop ileostomy. Stage 2: ileostomy reversal after 8–12 weeks.
• 3-Stage IPAA (for sick patients) — Stage 1: subtotal colectomy + ileostomy (emergency or high-risk). Stage 2: pouch creation + ileostomy. Stage 3: reversal after recovery.
• 1-Stage IPAA — selected low-risk patients; no temporary stoma. Rarely performed.

Pouch Function and Outcomes

• Average 5–7 bowel movements per day (vs 15–20+ during severe UC flare)
• Night-time continence preserved in 90%+ of patients
• 90%+ patient satisfaction at 5 years
• Pouch failure rate approximately 5–10% over 10 years
• Return to normal work, diet and exercise within 3 months