I think an end ileo is simple. They pull a bit of small intestine through the abdominal wall. I'd ask if they had ever had a case of leisions on or under a permanent ileo. It sounds like your pouch is failing. I know how upsetting that news is as I had my j-pouch removed a 16 months ago. But it was a great decision. My quality of life is much better without my sick j-pouch.