2nd Step (Takedown) - Jpouch Surgery and What To Expect ...

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Anthony1977
Regular Member


Date Joined Jan 2009
Total Posts : 413
   Posted 6/21/2010 12:09 PM (GMT -6)   
Well, I might as well ask this .... Anything to look out for, what will it be like waking up, recovery time at hospital, issues, blah blah blah ... ? I am going in 2.5 weeks. I am not as nervous as the first one, but it is still surgery and I am still kinda curious as to how things will be right after surgery into the first 3-5 days. Thanks, guys!!

capecodder33
Regular Member


Date Joined Oct 2009
Total Posts : 69
   Posted 6/21/2010 6:04 PM (GMT -6)   
well first off definitely check out these links.

mark & megan's UC to j-pouch story: ucstory.wordpress.com/surgery-3-jpouch-or-takedown-surgery/

and dennis' very informative j-pouch videos at ucvlog.com: ucvlog.com/past-videos/


the takedown surgery takes about an hour, which is a breeze compared to the first surgery which was 4 hours for me. they knocked me out good so i was groggy & slept most of all the first day. you'll probably have a catheter which will likely be removed 24 hours after surgery. i was hooked up to IV's until day 3. you won't eat solid foods until your intestines wake up and you start using the new plumbing. i began to go a little after a day following the operation.

expect to poop very frequently after your bowels wake up. you'll want to bring cream for "butt burn" if the hospital doesn't have any... calmoseptine is good (you can buy it through amazon.com). you'll be walking around on day 2. i was in the hospital for 4 days total, and was going to the bathroom maybe 13, 14 times daily when discharged. that number will decrease as the days and weeks pass. remember to still drink a lot when you're going so often (you can drink less eventually when your stools are more solid).

at the hospital they'll either staple your stoma "bullet hole wound" shut or let it heal on its down. it was the latter for me, and i just covered it up in the shower until it healed up.

my surgeon suggested a low residue diet for the first two weeks after surgery, and let me use imodium & metamucil a week after. i also use a daily probiotic to this day just for the hell of it. expect to have some pain & require pain meds for a little while, maybe a week following the op. the uncomfortable j-pouch spasm sensations will go away in time. expect some leakage, but it likely won't be an issue after a few weeks. anal sphincter exercises are recommended.

i was back at home after 4 days, driving after 7 days, could have sex in 10 days, and back to office work after 2 weeks. i was doing my routine field work (i have an environmental job) less than 3 weeks after surgery. everyone heals differently though. right now i'm 4 months post-op, use the bathroom maybe 8 times a day (and yes you can still pee standing up), experience no leakage or urgency, and can eat salads, corn on the cob, peanuts, buffalo wings, fast food, and have beer, wine, and plenty of coffee. :-)
Male, 30 years old. dx ulcerative proctitis 1987; left-sided ulcerative colitis in 1993.
Tried sulfasalazine, asacol, colazal, rowasa, prednisone, imuran, 6-MP, remicade, and humira.


J-Poucher since 2/11/10. Now UC free and healthy! :-)


NewShinyCD
Regular Member


Date Joined Oct 2009
Total Posts : 474
   Posted 6/21/2010 7:37 PM (GMT -6)   
Oh man, salads...and beer (although I'm more of a Smirnoff guy lol). Now I'm craving some Buffalo Wild Wings :p

I can't wait until I have my takedown. I get to see my surgeon tomorrow to get the rest of my staples removed (they removed every other one two weeks ago). I'm going to ask him to see if he can do a barium test in August as opposed to September.
21 y/o male livin' in Georgia. Diagnosed with Left-Sided Colitis in 2002; re-diagnosed with Pancolitis in Nov. 2009.
June 2010 I beat UC by having surgery.
Drugs tried: Just about every 5ASA medicine, enemas, prednisone, turmeric, fish oil, Remicade, psyllium seed powder, Metamucil.
Unable to take 6MP.
Step one of Jpouch surgery - 6/2/2010
Readmitted back to hospital because of blockage (my fault cause I ate Steak n Shake 3 days after being released from surgery) - 6/10/2010
Step two of Jpouch surgery - 9/?/2010


capecodder33
Regular Member


Date Joined Oct 2009
Total Posts : 69
   Posted 6/21/2010 8:08 PM (GMT -6)   
well, my stools are more diarrhea-like if i have a lot of spicy food and/or beer, but i'm going to enjoy myself anyway since i know there's no urgency in going or any disease to be wary of. and many foods are tolerated better the longer you have your j-pouch. if you can't tolerate something right after your surgery, try it again a few weeks later.

oh yea, baby wipes and soft TP are also recommended purchases.

both of you guys are younger like me, you'll be fine. the first two weeks are the worst, just get through those and it's likely smooth sailing after that.
Male, 30 years old. dx ulcerative proctitis 1987; left-sided ulcerative colitis in 1993.
Tried sulfasalazine, asacol, colazal, rowasa, prednisone, imuran, 6-MP, remicade, and humira.


J-Poucher since 2/11/10. Now UC free and healthy! :-)


Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 6/21/2010 9:03 PM (GMT -6)   
Make sure you have nice soft flushable wipes. They make a big difference over toilet paper. My son was given a barrier cream at the hospital but any baby rash - type cream will do. The first few weeks your BMs will be very watery and often. My son had some leakage the first couple of nights but that stopped every quickly. As soon as you start on solid food the stools will become thicker which also helps greatly with any butt burn. Our surgeon does not want any patients to use imodium etc for 6 weeks. They want to see what the body is going to do naturally first before they start slowing things down. All surgeons have their own thoughts on this issue....I know a lot of people start out with imodium after a couple of weeks.

The operation itself is very quick and simple. You should be in and out in about an hour. Pain is obviously much less than your last surgery. Our surgeon does not insert a bladder catheter since they expect you up and moving so much quicker.

Recovery time...you should be out in about 4-5 days. They need to see that you are eating okay and that everything is moving through properly. So for us, I believe, it was a day of no intake then a day of ice chips/water sips, day of liquids, then day of solids and then a day to make sure everything was going through okay...in all 5 days.

I was actually shocked how quickly my son's body adapted to the pouch. It still amazes me but within a few weeks the stools were actually "formed", although skinner and quite small. Very quickly the number of movements diminished and he now (4 months post surgery) sleeps through most nights (however, this is not 10 hours....he might go 6-7 hrs, gets up to have a BM and then back to sleep for another few hours)

If you have any other questions just ask. Soon this will all be over and you will be back to living your old life. yeah

NewShinyCD
Regular Member


Date Joined Oct 2009
Total Posts : 474
   Posted 6/21/2010 9:55 PM (GMT -6)   
Yea my bag doesn't fell up that often, so I'm hoping that will carry over when I have the jpouch. In the past 4 weeks I've only got up during the night maybe 4 times to empty and that was just once at night.

The problem I still have and its starting to diminish a little but I still worry about it is the leaking at night. During the day I'm being able to tell/hold in the mucus like stuff that tries to come out, and it has lessened a lot in the last few days, but at night there is always a lot, and I have to wear those pad things.
Some times during the day, though, it sometimes a little seeps through. This doesn't mean that I won't be able to hold stuff in after the j-pouch surgery will it?
21 y/o male livin' in Georgia. Diagnosed with Left-Sided Colitis in 2002; re-diagnosed with Pancolitis in Nov. 2009.
June 2010 I beat UC by having surgery.
Drugs tried: Just about every 5ASA medicine, enemas, prednisone, turmeric, fish oil, Remicade, psyllium seed powder, Metamucil.
Unable to take 6MP.
Step one of Jpouch surgery - 6/2/2010
Readmitted back to hospital because of blockage (my fault cause I ate Steak n Shake 3 days after being released from surgery) - 6/10/2010
Step two of Jpouch surgery - 9/?/2010


pam222
Veteran Member


Date Joined Jun 2009
Total Posts : 985
   Posted 6/21/2010 10:43 PM (GMT -6)   
I had leaking before takedown but have not had any since
27/F Diagnosed with unspecified UC 11/08 (symptoms for over a year before)
Asacol, Prednisone, Remicade with no success--no remission for over 2 years
8/09 colonoscopy shows that the whole colon is affected
12/18/09 Removal of colon, creation of J-Pouch and ostomy; recessed stoma; 12/30/09 Takedown too soon; RV fistula;1/9/10 Second Ileostomy Surgery;
1/25/10 Stoma Revision Surgery; 3/30/10 Takedown again
6/9/10 Scope and Biopsy--Diagnosed with Crohns Disease
Flagyl 500mg (3/day), Prednisone 40 mg, Culturelle, D, B12, Iron (2/day), Starting Humira soon


Anthony1977
Regular Member


Date Joined Jan 2009
Total Posts : 413
   Posted 6/22/2010 10:06 AM (GMT -6)   
Thanks, guys. My bag tends to fill (I use this term loosely because I empty it even when there is only a tiny bit in there) Just like having that empty feeling in it. I will def take and utilize these words of wisdom. I am just looking forward to all of this doctor stuff to be over with right now and just get moving on with things.
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