What is an ileal pouch?

When the entire colon and rectum have to be removed, the patient is faced with either a permanent ileostomy, or , to allow the child to defaecate through their anus, the creation of an ileal pouch.

Many patients are confused about what life with a pouch will be like. Based on the children who I have created a pouch for, this is what you can expect.

Most children stool around three times per day. My best patient stools once per day; at the other end of my results I have a child who can stool up to eight times per day. You should not expect to be incontinent. None of my patients have described bladder or sexual dysfunction.

A small number of children unfortunately cannot have a pouch constructed because the blood supply to their small bowel is not physically long enough to allow the pouch to reach the anus; I have seen this in 2 children of the 46 who I have attempted to form a pouch in.

The major benefit of the surgery is however, the cure of colitis, with the resultant improvement in quality of life.

There is no doubt that many women have difficulty in conceiving after pouch surgery. My own view is that the use of laparoscopic techniques leads to dramatically fewer pelvic adhesions which are the cause of the infertility.

I hope to publish some videos showing the excellent condition of the pelvis in girls who have undegone laparoscopic pouch surgery shortly.