Frequently asked questions of people
with the ileo-anal pouch
by Grace Williams, RNC, ET
Ms. Grace Williams is an registered Enterostomal Therapy (ET) nurse who scrubbed in on one
of the first pouch surgeries performed in Philadelphia over 12 years ago. Soon afterward,
along with Dr. Moreye Nusbaum, she started the first ileoanal support group in the
country. This group continues to meet on a monthly basis.
Last year, Grace retired from her ET position however remains actively involved with the
Crohn's and Colitis Foundation. She is the professional leader of the ileoanal support
group and has provided a helping hand to many individuals considering and undergoing pouch
1) What can I eat once I have my "pouch" ?
- Almost any foods. It is trial and error. Try small amounts of foods for any reaction.
Anything in moderation. If you had a lactose intolerance before surgery, it may persist
afterward, but medication like Lactaid can help.
See our Dietary Guidelines
2) Will I have a normal sex life?
- Both men and women should be able to resume a normal sex life following surgery. There
is a very small risk of injury to males during surgery which could cause impotence. Over
10 years in our support group, no men have experienced sexual difficulty following
surgery. Women have become pregnant and have delivered healthy babies both by C-section
and through vaginal delivery.
3) Will I have to take medications?
- Not necessarily. Most people taper off steroids within weeks of surgery. However, if you
have been on steroid therapy for a prolonged time, low dose maintenance may be needed.
Some people require medication or fiber therapy to decrease the number of stools per day.
The surgery is the cure!
4) Will I ever get ulcerative colitis again?
- No, the surgery plus removal of the mucus membranes in the anal area removes this
problem. If there is no colon, you can't have colitis. Removing the colon also takes away
the chance of colon cancer. However, there may be a small amount of rectal tissue that
remains after surgery that should be checked periodically by your surgeon.
5) How many bowel movements can I expect?
- In the early weeks there can be 8-10 stools per day (some people initially have more)
but as the pouch matures (usually in 3 to 6 months- in some people longer) the number
diminishes to an average 5-6 stools per day. Also foods can effect the number of movements
6) Is the surgery painful?
- There is the usual post-operative pain in the incision however medication can control
the amount of pain. The pain subsides considerably over the first 3 days post operatively.
After that there is gradual tapering of pain medicine. Most people find that they no
longer need pain medicine after a few days at home.
7) Do any people having the pouch regret it?
- Most patients having had this surgery are very satisfied. Almost all persons who chose
this surgery would choose it again if given the choice. No more pills, no pain, no bloody
diarrhea. Many people talk about "waiting for the other shoe to drop" (the next
attack as it were) because they have gotten so used to living with the disappointments of
chronic illness. As time passes you get past the feeling that disappointment is just
around the corner. Forget it, it's out of here. This is your new life.
8) Are there complications?
- Yes, complications are possible. People can develop adhesions, blockages (due to food
not well chewed), fistulas, and strictures, pouchitis- all of these are treatable.
Extremely rare is an anastomosis leakage, which may require a temporary ileostomy while
the area heals and then closing the ileostomy and letting the pouch function again.
Your surgeon will make all attempts to prevent any problems but problems can occur.
Remember to keep in contact and with your surgeon, gastroenterologist and ET nurse and ask
For More J-Pouch Questions and Answers, please see our Q & A page.
Remember: Some of your questions and answers may be