After a patient has had a total proctocolectomy (removal by surgery of the large intestine and rectum), a procedure called ileal pouch-anal anastomosis (IPAA) is performed.
In an IPAA, the ileum, or lowest part of the small intestine, is connected to the anus to create a structure (pouch) that can store and eliminate stools.
The surgeon creates a J-pouch (which resembles the letter J) to provide for the storage area. Other pouch shapes (S and K) are also possible. The pouch helps improve the patient’s quality of life and reduces the risk of growths that could develop into cancer. However, after this surgery, some patients may get pouchitis.
Pouchitis is an inflammation (swelling) of the pouch that occurs when the pouch becomes irritated and inflamed. The inflammation can cause increased bowel frequency (having to go to the bathroom more often), abdominal cramping or bloating, lower abdominal pain, or sometimes blood in the stool. This condition should be evaluated and managed by an experienced gastroenterologist.