Question about surgery for UC (J-Pouch)

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Robert.K
Regular Member


Date Joined Nov 2007
Total Posts : 137
   Posted 12/1/2007 11:20 AM (GMT -7)   
Hello everyone,
 
I'm curious if it's possible for a UC patient to have his/her FIRST surgery be a J-Pouch surgery? Let's say an UC patient requires a colectomy, does he or she initially require the stoma bag or can he or she immediately have the J-Pouch completed?
 
Thanks in advance for answers.

tjf
Veteran Member


Date Joined Dec 2005
Total Posts : 3238
   Posted 12/1/2007 11:23 AM (GMT -7)   
Hey! I can't answer your question but definitely check out www.jpouch.org. This is the website we usually recommend regarding sugery questions. We do have several members that have had surgery so hopefully you will hear from them soon.
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Robert.K
Regular Member


Date Joined Nov 2007
Total Posts : 137
   Posted 12/1/2007 11:45 AM (GMT -7)   
Thanks for the quick reply, i couldn't find the answer on that site, though (I checked it out yesterday). Thanks :-)

suebear
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Date Joined Feb 2006
Total Posts : 5698
   Posted 12/1/2007 1:24 PM (GMT -7)   

It depends upon a few things: 

1. How sick the patient is going into surgery'

2.  How long the patient is on prednisone and to what dose prior to surgery

3.  The final decision comes when the surgeon opens you up.  At that point he or she will determine whether or not you are a good candidate for what's called a one-step (no temp ostomy).

If you consult with a surgeon they will ask you which procedure you prefer (1 or 2 step) and then hopefully you get the surgery you selected.

 

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 


Robert.K
Regular Member


Date Joined Nov 2007
Total Posts : 137
   Posted 12/1/2007 1:45 PM (GMT -7)   
Thanks for the reply, Sue. I'm just kinda curious because I'm about to begin Remicade treatments, hopefully that will do the trick for me. But I'm beginning to reach the end of the line, so to speak, as far as non-surgical treatments. My specialist tells me that since he works at a school as well he has access to more experimental treatments (i.e. Humira), but as far as conventional treatments... if Remicade doesn't do the trick for me it's not unlikely that I'll require surgery. That being said, 50% of my colon is affected so I don't anticipate that I'll require a complete colectomy, rather, just the diseased part of my colon would be removed.

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 12/1/2007 2:20 PM (GMT -7)   

Robert,

If you have UC the standard surgery is complete proctocolectomy (removal of the entire colon and rectum).  The reason this is done is that UC will return to the unaffected colon or rectum if not removed.  Some people have had partial surgery for UC only to struggle again with UC, all the meds, and then end up eventually having the rest of the colon/rectum removed.  I would run very fast from any surgeon who proposes a "partial" surgery unless they can give compelling reasons why this would make sense.

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 


Robert.K
Regular Member


Date Joined Nov 2007
Total Posts : 137
   Posted 12/1/2007 2:52 PM (GMT -7)   
Thanks again for the reply, Sue. Again, I'm getting a bit ahead of myself here, as I have not yet discussed surgical options with my doctor. He didn't recommend partial surgery, it was simply my own speculation. Thanks again for the infomation! Hopefully the surgical route isn't in my cards for the future, but either way, I'm not afraid of whatever might have to be done :-)
 
EDIT: Sue, reading your signature I can see that you've had a J-Pouch surgery performed. Did you do the one-step J-Pouch surgery you were discussing in your original post in this thread, or did you have a conventional colectomy and then a subsequent reversal?

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 12/1/2007 6:22 PM (GMT -7)   

Robert,

I asked for a 2-step surgery.  I had been very ill in a 2+ year flare.  All I really wanted was to have good health and I thought the fastest way to acheive it was by doing the surgery in 2 steps.  I had my temp ostomy for 8 weeks and then had the reversal.

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 


Robert.K
Regular Member


Date Joined Nov 2007
Total Posts : 137
   Posted 12/1/2007 6:41 PM (GMT -7)   
Sue, why was it done in two steps? Thanks again for the quick replies. would it have been more risky or taxing on your physically to have recovered from a 1-step J-Pouch surgery?

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 12/1/2007 7:57 PM (GMT -7)   

I don't know if it would have been more risky to have my surgery done in a 1 step.  Since I specifically asked for a 2-step the discussion between a one and 2 step seemed moot.  This surgery can be done in a 1, 2, or 3 step process.  3 steps is done when either the patient is very ill or in an emergency situation (i.e., toxic megacolon).  I went back to work 3 weeks after my step 1 surgery, 8 weeks later I had the reversal and went back 3 weeks after that.  I think recovery would have been the same with a 1 step but I would have been home for 6 consecutive weeks instead of breaking it up into two-3 week recoveries.

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 

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