The ileoanal J-pouch

The ileoanal J-pouch (also known as the IPAA, the pull-through, and the J pouch)

The ileoanal J-pouch operation involves creating a reservoir from the intestine and connecting it to the anal canal. The usual outcome

is having from 4 to 7 stools per day, and being able to defer a bowel movement for up to an hour from the first urge. Unfortunately, a significant percentage of patients with the J-pouch operation have a poor outcome. A failed j-pouch can involve many stools per day, incontinence with stool leaking out of the anus without control, and chronic irritation and pain. People with a failed J-pouch can undergo creation of a BCIR (Barnett type of Kock Pouch), thereby avoiding a conventional ostomy with its external appliance. If a failed J pouch has already been removed and there is a conventional stoma, ileostomy reversal surgery can be performed.

People who have undergone the Kock pouch operation over the years can develop complications, as is true of all the surgical options. Difficulty with intubation (inserting the drainage tube/catheter) can occur, as well as incontinence of waste and/or gas, or a fistula can develop (an abnormal connection between the pouch and the abdominal skin). Surgical revision of a malfunctioning Kock pouch allows for the pouch to be transformed into the BCIR using the Barnett pouch technique with its intestinal collar design. This revision avoids the need for a traditional ostomy.