Ileal Pouch Reconstruction Results

Ileal pouch reconstruction at UW Health in Madison, Wisconsin, has allowed patients with conditions such as ulcerative colitis, familial polyposis and certain types of colon cancer to avoid living with a permanent ileostomy and external appliance after colectomy.
After ileal pouch reconstruction, stool frequency and continence are the two main factors that determine optimal pouch function.
Stool Frequency
Patients who have four to five bowel movements a day with nearly perfect continence are considered to have the best functional results. A variety of factors, including age, eating habits, type of reservoir reconstruction and quality of the anal sphincter muscles can affect stool frequency.
At the time of the ileostomy takedown, the ileal reservoir has a fairly small capacity. Therefore, it's not uncommon to have 10 or more bowel movements a day. As the ileal reservoir adapts and stretches to its normal capacity, stool frequency will decrease.
Most patients experience a decline in stool frequency during the first six to 12 months after surgery. Younger patients usually have fewer bowel movements than older patients. Other factors that can affect frequency are the amount of fiber in your diet or use of products such as Metamucil®, Lomotil® or Imodium® that help decrease stool frequency.
During the early years of pouch reconstruction, continence was a major problem. However, current techniques give approximately 95 percent of patients near-perfect control during the day and 90 percent good to excellent control at night. Adjusting your eating habits and using certain medications can improve continence.