What you can expect

Before the procedure

A nurse will see you before your surgery to mark the ileostomy site. Several factors affect ileostomy site selection, including your natural skin folds, muscles in your abdomen, scars, navel, waistline, hip bone and visibility of the site when you are sitting. Selecting the proper location makes it easier to care for the ileostomy after surgery.

Food and medications

Before your surgery, talk with your doctor about your use of caffeine, alcohol, tobacco or other drugs. Using any of these products before or after surgery may affect your healing and recovery.

During the procedure

When possible, surgeons perform J-pouch surgery using minimally invasive (laparoscopic) methods. Instead of opening the abdomen with a relatively large incision (open surgery), they typically make more than one smaller abdominal incision through which surgical instruments and a long, narrow tube with a camera at its tip (laparoscope) can be inserted.

During J-pouch surgery, the surgeon will:

• Remove the entire colon and rectum, preserving the muscles (sphincter) and opening (anus) at the end of the rectum
• Construct a pouch shaped like the letter J from the end of the small intestine and attach it to the anus (opening at the end of the rectum)
• Construct a temporary opening in the abdominal wall (ileostomy) for eliminating waste

After about three months of healing, the surgeon does a second procedure to close the ileostomy, allowing you to pass stool normally.

After the procedure

You'll spend a brief time in the hospital recovering and learning how to care for your temporary ileostomy. You may be given pain medication or antibiotics.

Your doctor is likely to recommend drinking lots of fluids, such as water or electrolyte replacement drinks, to avoid dehydration and loss of electrolytes. For about six to eight weeks, you should avoid certain foods, such as those high in roughage, including raw fruits and vegetables, seeds, nuts and popcorn. These foods can irritate the anal area. If your stool is watery, it may be helpful to eat certain foods, such as applesauce, bananas, rice or peanut butter.

For about four to six weeks after J-pouch surgery, avoid lifting and strenuous activities. After that, most any activity you choose will speed the healing process. The level and type of exercise you choose may depend on the exercises you were comfortable with before surgery.