Second j-pouch

Well, it is a quite individual thing. If you lost a lot of small intestine with the first surgery, it could be an issue. But, ordinarily you should have plenty for a second j-pouch.

There is roughly 20 feet of small intestine. It takes 6-12 inches to make a j-pouch. You can lose several feet without it affecting your ability to absorb adequate nutrition. There can be other obstacles, like a short mesenteric blood supply. So, it all depends on your specific anatomy.

You may want to get a second opinion.

Jan

Thanks, @Jan Dollar. You always have a calm, informative post to cheer me up.

I am actually getting a second opinion next week. It will be over the phone – bit weird – but the surgeon has my scans. I don’t believe I lost any extra small intestine than usual in my first surgery.

I will feel a bit better equipped to ask questions.

I have come to the conclusion that a permanent ileostomy is not for me. I know many people can manage and live with an ileostomy very well, but I am not one of them. I’m 46 years old and know myself pretty well by now. I think I could handle the consequences of a shortened transit much better.

I am going to see my original surgeon again as well, as it has been some years since he gave me the news.

The other complication is that I developed megapouch after 15 years. It could happen again in another 15 years. There are so few cases of megapouch that nobody knows.

It might be possible to do a pouchpexy (pouch repair) as a way to salvage your current pouch. Something to ask about anyway.

Jan