Question about the period in between j-pouch formation and take down.

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Regular Member

Date Joined Nov 2010
Total Posts : 111
   Posted 5/20/2011 11:46 AM (GMT -6)   

If you've had a 2-step j-pouch, this question is pertaining to the time between the first and second step. If you had a 3-step, it pertains to the time between the second and third steps.

So my j-pouch has been formed and I have a loop ileostomy that reroutes everything before reaching the j-pouch. My question is, since stool is rerouted kind of high up in the digestive tract, is it going through enough ileum? I know that B-12 is absorbed only in the ileum, and I've been feeling pretty unenergetic lately, and I wonder if I'm using enough ileum right now to get proper B-12 absorption. I have to think, though, that my doctor would have anticipated this being a problem if it were.

Thanks guys! I know I'm probably overthinking everything. :\

Veteran Member

Date Joined Dec 2010
Total Posts : 3332
   Posted 5/20/2011 1:34 PM (GMT -6)   
Have you had your B12 level checked? It's just a regular blood test, so maybe not a bad idea.

Didn't you just get out of the hospital pretty recentl? You could just be tired from the surgery and complications.....
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

New Member

Date Joined Apr 2011
Total Posts : 13
   Posted 5/21/2011 12:58 AM (GMT -6)   
i agree with bluglass, but its true that your body will absorb less vitamins in general (and less B12 specifically) so that could effect your energy level. I highly recommend taking liquid vitamins - they are much easier for your body to absorb and after a few weeks will helpf you feel more energized. I look forward to taking them once I get out of the hospital!
Good luck and keep us posted.
~ jeannemarie
Dx UC in 2004. No real issues till Nov. 2009 - huge flare. Allergic to remicade, non-responsive to Humira. Steroid refractory. Dx as indeterminate, April 2010.
Total colectomy w/ jpouch formation, May 2010.
Pain/inflammation in diverted Jpouch, June 2010 - present. On Cipro, Flagyl, Prednisone, Azathioprine. Dx Chron's Oct. 2011 (disputed).
Scheduled Jpouch removal & permanent Ileo, May 19 2011

Veteran Member

Date Joined Aug 2006
Total Posts : 6571
   Posted 5/21/2011 1:11 AM (GMT -6)   
Liquid or chewable or sublingual vitamins are best. I take cbewable calcium, flintstones, a.b complex,.and a subingual b12.
UC for 8 years, before finally kicking its butt and having a permanent ileostomy April 17 2007!
-I have gone to find myself, if i get back before i return, keep me here-
No matter what kind of day you are having, take five minutes to sing loudly and dance like a fool!

Regular Member

Date Joined Jun 2009
Total Posts : 30
   Posted 5/21/2011 3:19 AM (GMT -6)   
With a loop ileostomy B12 will not be being absorbed as it is absorbed in the terminal ileum. However unless you have had a loop ileostomy for 2-3 years this will not be a problem. The liver stores a number of years supply of B12 and will simply use that until it runs out. You are much more likely to be suffering a lack of electrolytes i.e. sodium and potassium because of extra fluid loss.


Forum Moderator

Date Joined Feb 2003
Total Posts : 1251
   Posted 5/21/2011 5:28 AM (GMT -6)   
It does take a while (months) for B12 deficiencies to become apparent. Symptoms are fatigue, confusion, depression, poor appetite, etc (all of which I would discard at this time since you'll be feeling those symptoms due to surgery anyway). It's only if you're still feeling like that months down the track that it might be something to look into.
Ileostomy for 34 years due to UC. I had my surgery at 10 years of age.

Moderator of the Ostomy and Psoriasis Forums


I'm not a complete idiot - some parts of me are missing!

Forum Moderator

Date Joined Feb 2006
Total Posts : 5698
   Posted 5/21/2011 7:31 AM (GMT -6)   
Most jpouchers do not have B-12 issues and do not have a compromised ileum.  However, checking your B-12 levels should be done annually by your GP whenever you get blood work taken.  Ask to have that looked at if your GP overlooks it.
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