Ileal pouch anal anastomosis at Exeter Hospital

What happens during ileal pouch anal anastomosis?

Ileal pouch anal anastomosis is performed under general anaesthetic.

This procedure is often done in 2 stages, depending on your own situation.

Stage 1 of the procedure

Your surgeon will remove your large intestine. Then they'll create a pouch using the end of your small intestine (or ileum)

You may need a temporary ileostomy to allow stool to pass from your small intestine to an opening in your abdomen called a stoma. 

Having a stoma means faeces will leave your small intestine through an opening in your abdomen and pass into a bag that is emptied or replaced periodically. This procedure will allow the area to heal without the danger of infection.

Stage 2 of the procedure

About 2 months later, your surgeon will then attach the pouch to your anus (back passage). The medical term for joining or connecting tube-like structures in your body is anastomosis.

This pouch will now allow you to store stool and pass it as normal through your anus.

Finally, they'll close the opening in your abdomen.

Recovery from ileal pouch anal anastomosis

You'll be given medication to control any post-operative pain. Be sure to tell one of our healthcare team if you're uncomfortable.

After the first stage of surgery, you may need to stay in hospital for 5–7 days. Once you pass wind and stool, you can begin to take fluids by mouth. Your diet will by gradually increased over the next few days. A nurse will teach you all about managing your temporary stoma.

Recovery from the second stage of surgery may be shorter, based on your own medical condition. You may find your bowel movements are more frequent.

Make sure you follow any dietary or activity restrictions and attend any follow-up hospital visits.

It can take up to 12 months for the frequency of your bowel movements to decrease.

Complications of ileal pouch anal anastomosis

As with any surgical procedure, there's a small chance of complications, including:

• bleeding
• pain
• infection
• bruising.

Specific complications of ileal pouch anal anastomosis may include:

• leaking of the pouch
• infection in the pouch (pouchitis)
• obstruction or blockage in your intestine
• drainage from the anus.

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.