OMG! My J-Pouch is Going to Fail!?


My J-Pouch is Doomed: J-Pouch Failure Risks

On Friday I got an email from Ostomy Connection talking about the risks of having a failed J-Pouch. j-pouchfailTo be honest, I was a little annoyed and perturbed by the article. I realize that the article was written by an expert, but the title is misleading and scares patients!

The first thing I had a problem with is that the article never actually discusses the risks of having a failed J-Pouch, despite the click-bait title. The article simply points out some complications that someone with a J-Pouch could experience. I have talked about these risks in a previous blog post, and you can read it here.

Of Course There Are Risks

Yes, there are risks when you undergo an IPAA (J-Pouch Surgery), but there are risks with every medical procedure, treatment or medication. It is up to you to do your research and work with your doctor to ensure the best possible outcome. You can weigh both risks and benefits of a J-Pouch vs an ostomy. For some, a J-Pouch just isn’t for them… and that’s ok… but for others, it’s a very viable option and approximately 94% of patients report a better quality of life as opposed to having a diseased colon. I realize you don’t always get a choice when your guts start busting on you… but sometimes you do.

The risks that come with a J-Pouch are often not severe and many of them are easily resolved or will resolve on their own without invasive medical intervention at all. And even if they do not resolve on their own, the risk for complications are very, very low.

Complications ≠ J-Pouch Failure

The Ostomy Connection article lists the following complications for the “risks of having a failed J-Pouch”:

  • Pelvic Sepsis
  • Leaks
  • Small Bowel Obstruction
  • Pouchitis
  • Fistula

None of these equal J-Pouch failure all on their own and more often than not, these complications aren’t immediately deadly. And just because these risks exist, does not mean that you are guaranteed to experience them (or lose your J-Pouch). I’ve been one of the lucky ones to not have any problems with any of these complications to date… knock on wood.

The success of your J-Pouch will depend upon multiple things: the experience of your surgeon, your overall health, inflammation levels and steroid use.

Six Percent Failure Rate

J-Pouch failure only occurs in about 6% of patients and as medical advances progress, the risks get lower and lower with each passing year. I would highly recommend that you find a surgeon who has done several hundreds if not thousands of J-Pouches during the course of his or her career. I have learned recently that the cost of care does not vary a great deal when selecting someone who specializes in the procedure. It’s ok, and I would say even imperative that you do your best to find a leading J-Pouch expert who can help reduce your risks of J-Pouch failure and stay on top of any possible complications before they become problematic.

My reason for writing this today is not to sway you one way or another. And I’m not against patients choosing an ostomy over a J-Pouch. In my mind, which procedure you choose should be based on your own preferences. My purpose is to caution you. My purpose is to encourage you to do your research and remember that a failed J-Pouch is a rare thing. Most patients living with J-Pouches go on to live a full life. Is a J-Pouch ideal? No. But it is a heck of a lot better than a bleeding, ulcerating, burning colon.