How a J-Pouch can Make Your Life Noraml Again

Chances are if you have been stricken with ulcerative colitis or a condition known as familial adenomatous polyposis (FAP), then you have probably also heard of the term J-Pouch. Medically, a J-Pouch is made out of a patient’s small intestine and gets connected to the patient’s rectal canal after removal of the rectum and colon. 

The procedure itself is known as a “Total proctocolectomy with or without ileal J-pouch anal anastomosis “and usually presents itself during childhood.

Ileoanal Anastomosis Techniques

There are two techniques currently available for ileoanal anastomosis and they are either by stapling via extrarectal dissection or by being hand-sewn via endorectal mucosectomy. Through endorectal mucosectomy it is believed to be able to remove a huge amount of diseased tissue and eliminate the amount of cancer, inflammation, or dysplasia that may remain. Regardless, there will always be risk that remains after mucosectomy. Not only that, but mucosectomy has not been shown to be able to eliminate any likelihood of neoplasia to occur in the pouch.

For an anastomosis that is stapled, the surgeon utilizes extrarectal dissection for proctectomy, which is able to maintain some anorectal mucosa in the area. Either a single or dual staple gets used in order for the anastomosis to be formed. With some of the anorectal mucosa being maintained, sensation in the anal region is able to be improved. This also improves the feeling of being able to eliminate waste, and allows the patient to regain their anal sphincter function.

The J-Pouch

Although there is more than one pouch that can be created, an ileal pouch is created the most during surgeries. With the shape of a “J”, its body includes two attachments known as the efferent and afferent limbs as well as a ‘U’ turn shape. When an endoscopy is performed, a healthy looking J-Pouch should appear as an eye of an owl, as the inlet of the pouch as one and the “J” dome as the other.

The Colonic J-Pouch

With a colonic J-Pouch, the surgeon uses a similar technique that is seen with ilial J pouches; however the colonic J-Pouch has to be a smaller size. The surgeon will use diverticula from the colon in order to create the pouch itself. As it’s constructed it must be assured that it reaches the distal rectal. There needs to be at least 6 cm measured in order for the efferent limb to be formed. The efferent limb then gets overlapped on the colon in order to be close to the borders of the anti-mesenteric.

What Function Does the J-Pouch Serve?

The function of the J-Pouch is to store the bodily waste that circulates through the intestine after digestion and absorption are complete. Not only that, but it also helps dispose of the waste. This enables a patient to have a bowel movement the same way as they could before.

What are the Requirements for a J-Pouch?

For a patient to be eligible for the J-Pouch procedure they must exhaust all other forms of treatment for their ulcerative colitis. Patients who commonly undergo this surgery include those with:

• Therapies that have faileed
• Familial Adenomatous Polyposis
• Ulcerative colitis that is chronic

J-Pouch Benefit

No need for an ostomy – Having a J-Pouch does not need ostomy supplies or stoma pouches. This will save a lot of money on supplies as well as producing comfort emotionally and psychologically. It also restores bowel control until you are able to relieve yourself.

During the healing process, you need to be aware that your body will need to adapt to the J-Pouch. During this time you may experience an increase in trips to the toilet or decreased amount of stimulation during intercourse.

 

Managing Ostomy with Fluids and Electrolytes

For those who are recovering from an Ostomy, there needs to be special care taken as you heal from any surgical procedure that stems from it. One of these treatments is ensuring that you are consuming appropriate amounts of Fluids and Electrolytes that can support intestinal recovery. Consuming Fluids and Electrolytes are key to preventing three key symptoms: Dehydration, Sodium Depletion, and Potassium Depletion. While consumption of fluids and electrolytes are key for any person's overall health, they are critical towards the recovery of intestinal healing for an individual that just had an Ostomy.

A person recovering from an Ostomy should be consuming at least 2 to 2.5 liters of fluids per day, and more than that in hotter weather. It is advisable to consume drinks high in salt and sugar called isotonic fluids, as these beverages tend to also contain electrolytes. Isotonic fluids are ones that tend to go straight to a person’s gut rather than end up in a stoma bag.

It is important that any fluids consumed have electrolytes, as too much water by itself can wash away existing electrolytes within the body. This does not mean you should not drink water as it is critical to maintain hydration levels, but rather consume a balance of water and drinks with electrolytes. It is advisable to limit sugar intake as sugar can also cause dehydration. You will also want to stick to foods with low osmolarity, as this will help regulate fluid in bowel movements tremendously.

While sports drinks such as Gatorade or Powerade may have electrolytes, you can also obtain key amounts of Sodium and Potassium through a select number of food options. Some of the key foods to consider for potassium intake are black-eyed peas, fish, pinto beans, bananas, chicken, oranges, raisins, yogurt, and vegetable soups. Some key foods to consider for sodium intake are cheese, pickles, salt, buttermilk, canned soups, and any other commercially prepared foods that require sodium based preservatives.

As far as things to avoid, it is advisable to stay away from caffeinated or alcoholic beverages. Caffeinated beverages will force kidneys to increase urine output which in return will increase your salt outtake. If you must consume caffeine than you will need to increase your water intake to keep adequate hydration levels as caffeine can cause dehydration due to the kidney’s response through increased urine output. Alcohol is always not recommended during surgical recovery as they can compromise an immune system that is crucial to be operating at optimal levels while your body is trying to heal.

Overall, it is critical that patients recovering from ostomy surgery take these dietary restrictions seriously. It was found through one study that nearly 50% of ostomy patients recovering from surgery were readmitted due to dehydration from improper consumption levels of fluids and electrolytes based on a high level of output stoma. Not only does this hamper recovery from ostomy surgery but could compromise the kidneys due to an increased risk of developing an ileostomy. Therefore, it is important to have self-awareness of when you may be developing symptoms within these three categories and act fast to treat them before you do more damage to your body.

 

 

Managing Ostomy with Fluids and Electrolytes

For those who are recovering from an Ostomy, there needs to be special care taken as you heal from any surgical procedure that stems from it. One of these treatments is ensuring that you are consuming appropriate amounts of Fluids and Electrolytes that can support intestinal recovery. Consuming Fluids and Electrolytes are key to preventing three key symptoms: Dehydration, Sodium Depletion, and Potassium Depletion. While consumption of fluids and electrolytes are key for any person's overall health, they are critical towards the recovery of intestinal healing for an individual that just had an Ostomy.

A person recovering from an Ostomy should be consuming at least 2 to 2.5 liters of fluids per day, and more than that in hotter weather. It is advisable to consume drinks high in salt and sugar called isotonic fluids, as these beverages tend to also contain electrolytes. Isotonic fluids are ones that tend to go straight to a person’s gut rather than end up in a stoma bag.

It is important that any fluids consumed have electrolytes, as too much water by itself can wash away existing electrolytes within the body. This does not mean you should not drink water as it is critical to maintain hydration levels, but rather consume a balance of water and drinks with electrolytes. It is advisable to limit sugar intake as sugar can also cause dehydration. You will also want to stick to foods with low osmolarity, as this will help regulate fluid in bowel movements tremendously.

While sports drinks such as Gatorade or Powerade may have electrolytes, you can also obtain key amounts of Sodium and Potassium through a select number of food options. Some of the key foods to consider for potassium intake are black-eyed peas, fish, pinto beans, bananas, chicken, oranges, raisins, yogurt, and vegetable soups. Some key foods to consider for sodium intake are cheese, pickles, salt, buttermilk, canned soups, and any other commercially prepared foods that require sodium based preservatives.

As far as things to avoid, it is advisable to stay away from caffeinated or alcoholic beverages. Caffeinated beverages will force kidneys to increase urine output which in return will increase your salt outtake. If you must consume caffeine than you will need to increase your water intake to keep adequate hydration levels as caffeine can cause dehydration due to the kidney’s response through increased urine output. Alcohol is always not recommended during surgical recovery as they can compromise an immune system that is crucial to be operating at optimal levels while your body is trying to heal.

Overall, it is critical that patients recovering from ostomy surgery take these dietary restrictions seriously. It was found through one study that nearly 50% of ostomy patients recovering from surgery were readmitted due to dehydration from improper consumption levels of fluids and electrolytes based on a high level of output stoma. Not only does this hamper recovery from ostomy surgery but could compromise the kidneys due to an increased risk of developing an ileostomy. Therefore, it is important to have self-awareness of when you may be developing symptoms within these three categories and act fast to treat them before you do more damage to your body.