IPAA Pouch Surgery (J-Pouch)

What is IPAA Surgery?

Ileal pouch-anal anastomosis (IPAA) removes entire colon and rectum, creates reservoir from small intestine (ileum), and anastomoses to anus. Definitive cure for ulcerative colitis preserving bowel continuity and avoiding permanent colostomy.

Indications for IPAA

Ulcerative colitis refractory to medical therapy
Familial adenomatous polyposis (FAP)
Dysplasia or cancer in IBD
Toxic megacolon
Quality of life severely impaired

Surgical Stages

Stage 1: Proctocolectomy

Removes colon, rectum. Creates ileal pouch and anastomosis. Temporary ileostomy created.

Stage 2 (2-3 months later): Ileostomy Reversal

Closes ileostomy, restores bowel continuity. Patient transitions to pouch.

Recovery & Outcomes

Total hospital stay 5-7 days. Recovery 8-12 weeks. Most patients 4-6 bowel movements daily after pouch adaptation (3-6 months). Excellent symptom resolution. Complication rate <5% with experienced surgeon. 85-90% patient satisfaction.

Bowel Function

Initially higher frequency, improves over time. Anti-diarrheal medications help. Dietary adjustments optimize function. Night pads may be needed initially. Most patients return to normal social activities.