Risks

J-pouch surgery has a few risks and complications, including ileostomy blockage, dehydration, diarrhea, narrowing of the area between the pouch and the anus (stricture), pouch failure, and infection of the internal pouch (pouchitis).

Pouchitis is one of the most common complications of ileoanal anastomosis. The risk of pouchitis increases the longer the J pouch is in place.

Pouchitis can cause symptoms similar to those of ulcerative colitis, including diarrhea, abdominal and joint pain, fever, and dehydration. Contact your doctor if you experience any of these symptoms. In most cases, doctors can treat pouchitis with antibiotics. A small number of people require medications on a daily basis to treat or prevent pouchitis.

On rare occasions, pouchitis doesn't respond to daily treatment. Then surgeons may need to remove the pouch and construct an ileostomy. Removal of the pouch occurs in only a small percentage of people with a J pouch.

Often as part of the surgery, the pouch is sewn to a small section of rectum called the cuff. For patients with ulcerative colitis, this remaining rectum may become inflamed with colitis, which is called cuffitis. For most people, cuffitis is usually treated successfully with medication.