A failed J-pouch can represent a significant risk to the health of those suffering from ulcerative colitis or Crohn’s. Unfortunately, failure of the J-pouch is commonly associated with rupture of the pouch, but in reality, the J-pouch can start to exhibit symptoms similar to inflammatory bowel disease, reports the study, “Inflammatory Pouch Disease: The Spectrum of Pouchitis.” As a result, those who have undergone surgery to create a J-pouch need to understand how to recognize the first signs of a failed J-pouch, including inflammatory pouch disease.
Inflammatory pouch disease (IPD) refers to the inflammation of the J-pouch, and it is most commonly seen in ulcerative colitis patients. In addition, the symptoms of IPD can be quite uncomfortable, which include the following:
IPD is caused when the epithelial cells within the J-pouch are exposed to feces that contain more bacteria than usual within the ileum. With time, these bacteria produce a UC-like effect on the pouch, which reduces the effectivity of the pouch. Unfortunately, researchers have yet to determine which bacteria are primarily responsible for this inflammation, but evidence suggests those with ulcerative colitis who have undergone surgery to create a J-pouch are at the highest risk for IPD and J-pouch failure.
Lifestyle choices also play a significant role in the failure of the J-pouch. For example, use of NSAIDs, corticosteroids, tobacco or alcohol increases the likelihood of developing IPD.
Those who develop IPD have several options. Initially, bacteria causing IPD may respond to antibiotic treatment, but IPD may require treatment temporarily or permanently. Furthermore, the bacteria may become resistant, and more invasive treatments may be required. As a result, the J-pouch may be adapted into a BCIR or an ileostomy reversal may be appropriate.
While a J-pouch can be an effective solution for those suffering from Crohn’s disease or ulcerative colitis, it does carry the risk of developing IPD. Fortunately, traditional or alternative ileostomy options are available to eliminate the pain and health risks of IPD. To learn more about surgical correction or reversal of a failed J-pouch, contact Dr. Don Schiller via the online contact form today.