Sadly, some children with ulcerative colitis must undergo surgery if they are to be restored to good health. In advanced countries, the "gold standard" operation involves the creation of a pouch.

The idea behind an ileal pouch is to recreate a resevoir to store faeces in the same way the normal rectum does.

The rectum is the last part of the bowel above the anus, and it normally stores faeces until we find it convenient to defaecate.

The operation was orginally described by a surgeon called Sir Alan Parks working in London.

The operation involves turning the last 15cm of the small bowel back upon itself to form a shape like the letter "J" (although there are other configurations), opening the common wall between the limbs of the J.

This is then connected to the anus when the large bowel, or colon (see my glossary on the other pouch page), has been removed.

We now perform this operation with keyhole surgery; see the link in the next box to our publication.