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I'm wondering if it will heal itself the way cut skin does and eventually reattach itself to my rectum or are sutures still securing it after over 20 years?   If so I'm surprised that sutures can last that long. Well I know there's staples and glue too.   I never asked my surgeon long ago what he used.   I still wonder how anything can last for that long though?

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The gut is pretty much like always-wet skin, with some local customization in each area. The inside of your mouth is a bit like it, customized for what a mouth does. The small intestine has characteristic folds for each portion, examples of which are most easily seen if you get adventurous with dim sum in a serious Chinese restaurant. One difference between healing in the mouth and healing of the J-pouch anastamosis is the the anastamosis is made from a full-thickness cut through the tubular intestinal wall. That's why I mentioned the scar tissue. 

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