Sara, let me begin by saying that the majority of people with J pouches do better in terms of pouch function than I did. I averaged around 12 bathroom stops a day, had butt burn , leakage and did have to watch my diet a bit. I learned over time how to get the best with what I had, knowing that the last thing I wanted was to get stuck with the bag (pun intended). I remember skiing all day at Vail, Colorado and deep sea fishing in Cabo San Louis, Mexico without a bathroom break. Although I had “accidents” and embarrassing experiences from time to time, I accepted that as the price I paid for avoiding a less desirable (in my opinion) procedure. During the 30 years I had the J pouch, I never had a blockage or pouchitis. I installed a bidet in my home which helped significantly with the anal irritation. There are a number of bidet “seats” available that are far less costly and easy to install on your existing toilet. Various skin barrier creams also helped. Although I had my difficult moments, I did not allow that to hold me back from enjoying life.
If my diagnosis of FAP occurred today, I would still go with the J pouch. Surgical techniques for the J pouch (as well as the K pouch and BCIR) have improved significantly since I first had mine. The most attractive feature of the J pouch is that it preserves the anal sphincter and allows you to “go” in the normal way. If you opt for one of the alternatives, the anus is removed and you will never know if the J pouch would have worked out well for you. One thing to seriously keep in mind is that these message boards are most frequently visited by people who are having problems with their pouch and are looking for solutions. Most folks who have few or no problems with their various procedures rarely visit these boards and just go about enjoying their life. Please free to send me a PM, if you wish.
Bill