I need to make a decision shortly to elect which type of surgery I am going to have - j pouch or permanent ileostomy. One of the questions I have is how do you know when you have to go with a j pouch and do you have to get there quickly? I want to get rid of that have to know where every bathroom is feeling.
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Missy75, for me the sensation of having to go with a jpouch
is much like the sensation of having to pee. It's a sense of
'fullness' that builds. Think of riding in a car on a trip;
you can get off at this exit and go; but maybe you feel
like waiting for the next exit; or the one after that. In
other words, it's not that sense of urgency that 'I have to
go NOW' that you have with UC. Prayers and Best Wishes as
you make your decision, Steve
I have more time to get to the restroom with my j-pouch as I can hold it much better than I could before the surgeries.

Best wishes for your surgery and remember you can take your time. You can go with an ostomy for however long you want to. Also after living with and ostomy you can decide when or if you want to go ahead with a j-pouch. The difference will be one extra sugery.
I second what Steve said about the feeling to go which gradually builds. You're able to choose when you want to go. It can get uncomfortable if you put it off for too long, just like if you hold off on peeing for too long.

Despite this, there are times when I make sure I know where the bathrooms are, but only when I'm dealing with a bout of pouchitis. Then the urgency is definitely a problem; however, pouchitis is usually treatable, so I didn't let that possibility deter me from getting a j-pouch.
When I have to go it feels like pressure down below and maybe a little bloated feeling from the gas. I can hold it for however long I like though. For example the other day I was up in the mountains fly fishing and had just put my waders on and made it to the middle of the stream when I realized I had to go! Instead of going to the bathroom right away I continued to fish for a few hours untill I had waded upstream to the next set of restrooms at a campground. Not once was I afraid I was going to fill my waders from the inside!

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