Ileostomy bag

Ileal Pouch

The ileal pouch, also known as an ileal pouch-anal anastomosis (IPAA), is a surgically created internal reservoir that is constructed from the terminal part of the small intestine, specifically the ileum. This procedure is typically performed on patients who have had their colon and rectum removed due to conditions such as ulcerative colitis or familial adenomatous polyposis (FAP).

Procedure

The ileal pouch-anal anastomosis procedure involves the creation of a pouch from the ileum, which is then connected to the anus so that the patient can eliminate waste normally. The pouch serves as a replacement for the rectum, which is typically removed during the surgery. The procedure is usually performed in two stages. In the first stage, the colon and rectum are removed, and the pouch is created and attached to the anus. In the second stage, the temporary ileostomy that was created in the first stage is closed.

Complications

While the ileal pouch-anal anastomosis procedure can greatly improve the quality of life for patients with ulcerative colitis or familial adenomatous polyposis, it is not without potential complications. These can include pouchitis, an inflammation of the pouch, and anastomotic leak, a leakage of intestinal fluid from the surgical connection between the pouch and the anus. Other potential complications include small bowel obstruction, fistula formation, and sexual dysfunction.

Management

Management of complications associated with the ileal pouch-anal anastomosis procedure typically involves medication, such as antibiotics for pouchitis, and in some cases, additional surgery. Long-term management may also involve dietary modifications and regular follow-up with a healthcare provider.

See also

• Colectomy
• Proctocolectomy
• Restorative proctocolectomy