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The guide explains how the large bowel is removed and a “new rectum” reservoir is created from the ileum and attached to the anal sphincter for more predictable bowel function. It covers common pouch types (such as the J pouch), reasons for surgery, benefits, staged operative options, and preoperative tests like colonoscopy and blood work.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ileal-pouch-anal-anastomosis-a-patients-guide-to-the-ileo-anal-pullthrough-operation/403876/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ileal-pouch-anal-anastomosis-a-patients-guide-to-the-ileo-anal-pullthrough-operation/403876.png","ImageObject",300,407,{"name":92,"@type":93},"asba","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is IPAA and why is it performed?","Question",{"text":113,"@type":114},"IPAA is an operation for ulcerative colitis or familial polyposis. It works by removing the diseased large bowel and creating a new rectum from the small bowel to store stool.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does the “J pouch” procedure create a new rectum?",{"text":118,"@type":114},"A pouch is made by sewing the end of the small intestine into a “J” shape, pulled through the pelvis, and attached to the anal sphincter muscle to form a stool reservoir.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the typical stages of the IPAA operation and what happens in each?",{"text":122,"@type":114},"The procedure may be done in one, two, or three stages, most often in two stages electively. Stages involve removing the colon and creating the pouch, using a temporary diverting ileostomy when indicated, and later removing the ileostomy after several weeks.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},403876,1790865200,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},3985747872567,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Ileal Pouch Anal Anastomosis  \nA Patient’s Guide to the Ileo-Anal Pullthrough Operation  \nUniversity of North Carolina Chapel Hill, N.C.  \nIntroduction  \nThe ileo-anal pullthrough procedure,(also known as the ileal pouch anal anastomosis procedure or IPAA) is an operation that has gained popularity over the past fifteen years, for the treatment of ulcerative colitis or familial polyposis. IPAA cures these diseases by removing the diseased large bowel.  \nThe operation removes the large bowel and creates a “new rectum”. This is done by making a pouch out of the end of the small bowel (ileum), and attaching it to the anal sphincter muscle. This creates a reservoir for the storage of stool, allowing for predicable and controllable bowel movements.  \nThere are several types and names of pouches that can be created. The most common one is the“J pouch”. The pouch is made by taking the end of the small intestine and sewing it into a “J” shape. The pouch is then pulled through the pelvis and sewn to the anal sphincter. That is why it is commonly referred to as the “pullthrough”procedure.  \nCreation of the “J Pouch”  \nThe IPAA is a major operation. It may be performed in one, two, or three stages. When it is performed electively, not as an emergency, it is usually done in two stages. It is less commonly performed in one stage, only if the surgeon feels it is medically and technically safe. If a patient is very sick, on large doses of steroids or other immunosuppressive drugs, or if the operation is performed asan emergency, it may be safer to do IPAA in two or three stages.  \nReasons for having the IPAA include:  \n• Increased risk of cancer  \n-the presence of dysplasia on colonic biopsies  \n• Failure of medical management  \n-colitis not responding to medical management  \n-bleeding  \n-complication from medication  \n\n| Reason for Surgery 1990-1996 |  |  |\n| --- | --- | --- |\n| 78% |  Medical Failure |  |\n| \u003Cbr>6% 3% 3%\u003Cbr>10% | | Dysplasia Bleeding Stricture Toxic |\n\nBenefits of this operation include:  \n• The disease is cured because the large bowel is removed.  \n• Disease symptoms such as diarrhea and urgency are eliminated.  \n• You will not have to take medications for the disease.  \n• Screening colonoscopies/ flex sigmoidoscopies for cancer are no longer required.  \n• You will feel better and have more energy.  \nOperative Stages  \nOne Stage  \nOperation \\# 1  \n* Remove colon and rectum  \n* Make pouch and sew to anus  \n* No temporary ileostomy  \n* 4-5 hour operation  \n* 7-10 days in the hospital  \nTwo Stages A  \nOperation \\#1  \n* Remove colon and rectum * Make pouch and sew to anus  \n* Temporary diverting ileostomy  \n* 4-5 hour operation  \n* 5-7 days in the hospital  \nOperation \\#2  \nTakes place at least 6 weeks after \\#1  \n* Takedown of ileostomy  \n* 1-3 hour operation  \n* 3-6 days in the hospital (with an  \naverage stay of 4 days)  \nTwo Stages B  \nOperation \\#1  \n* Remove colon  \n*Leave rectum and anus  \n* Ileostomy  \n*2-3 hour operation  \n*5-7 days in the hospital  \nOperation \\#2  \nTakes place at least 6 weeks after \\#1  \n*Remove rectum  \n*Make pouch and sew to anus  \n*4-5 hour operation  \n*No ileostomy  \n*5-7 days in the hospital  \nIleal Anastomosis  \nThree Stages  \nOperation \\#1  \n* Remove colon  \n* Leave rectum and anus  \n* Ileostomy  \n* 2-3 hour operation  \n* 5-7 days in the hospital  \nOperation \\#2  \nTakes place at least 6 weeks after \\#1  \n* Remove the rectum  \n* Make pouch and sew to anus  \n* Temporary diverting ileostomy ***  \n* 4-5 hour operation  \n* 5-7 days in the hospital  \nOperation \\#3  \nTakes place at least 6 weeks after \\#2  \n* Takedown of ileostomy  \n* 1-2 hour operation  \n* 3-5 days in the hospital  \nFor purposes of this pamphlet, IPAA will be explained as an elective operation, involving two stages. Your surgeon will discuss with you whether you will be a candidate for a one, two, or three stage operation.  \nBefore the First Operation:  \nThe first operation involves removing your large intestine and creating the po","cbCaiq73dhmGCxnU","https://ap.wps.com/l/cbCaiq73dhmGCxnU","pdf",721262,16,"English","# Introduction\n## Creation of the “J Pouch”\n## Reasons for Having the IPAA\n## Benefits of the Operation\n## Operative Stages\n## Before the First Operation","[{\"question\":\"What is IPAA and why is it performed?\",\"answer\":\"IPAA is an operation for ulcerative colitis or familial polyposis. It works by removing the diseased large bowel and creating a new rectum from the small bowel to store stool.\"},{\"question\":\"How does the “J pouch” procedure create a new rectum?\",\"answer\":\"A pouch is made by sewing the end of the small intestine into a “J” shape, pulled through the pelvis, and attached to the anal sphincter muscle to form a stool reservoir.\"},{\"question\":\"What are the typical stages of the IPAA operation and what happens in each?\",\"answer\":\"The procedure may be done in one, two, or three stages, most often in two stages electively. Stages involve removing the colon and creating the pouch, using a temporary diverting ileostomy when indicated, and later removing the ileostomy after several weeks.\"}]","Ileal Pouch Anal Anastomosis - A Patient’s Guide to the Ileo-Anal Pullthrough Operation | PDF",1790544328]