Hello everyone, it’s Hannah! In early December of 2020, I had my ostomy reversal or takedown surgery to create my J-Pouch. I knew from talking with my doctor some of what to expect: waking up with lots of tubes, feeling tired and sore. But it was through reading articles about other people’s J-pouch experiences (those who just had surgery and those who have lived with their pouch for some time) that I was able to prepare myself for what to anticipate physically after surgery. Looking back now, I realize I’ve learned a lot, that there are things I wish I had known, and that I want to share what I’ve learned so others can know what to expect.  

Personally, I didn't feel too nervous going into my operation, but I felt really nervous about not knowing what to expect afterwards. Now that I've had surgery and have lived with a new J-pouch for a couple months, I realize that I wish I had known more about things like how I might react to certain foods, about pouchitis, the relationship between food restriction and blockages, what it was going to feel like waking up from surgery, and so on. I put together a list of tips and things to know based on my experience:

Before Surgery

  • A couple of months before, start to use your butt muscles more often. This way, when you start learning how to use your J-pouch, you will be able to hold it better

After Surgery

  • Post-surgery you will still need to intermittently check in with your GI doc
  • You might wake up with a lot of tubes, but honestly, I was so tired that I didn’t notice until the next day
  • The more rest I got, the better I felt
  • I started walking the day after surgery, and the more I walked the better I felt (I pushed myself a little, but listened when my body was done)
  • I had to go to the bathroom a lot at first 
  • When I had an urge to use the bathroom, I usually went. But if I was able to hold it, for even a short time, it helped build up more muscle

Discomfort After Surgery

  • Remember everybody is different. Your experience will be different than others. If something doesn’t seem right, you should contact your care team and discuss it with them
  • If your rectal area gets irritated, there are creams that help with irritation (I used an ointment called Calmoseptine)
  • I used Tylenol as my over-the-counter pain reducer (this is something you should decide with your doctor)
  • I felt better overall when I drank lots of water
  • If you are someone who gets a period, just know it may be tougher and more painful right after surgery. That was my experience. But the next couple of times I got it, it felt fine

Food & Eating After Surgery

  • Each person is different. You will learn as you go about how different foods affect you (keeping a food journal can help you notice what works and what doesn't when it comes to food)
  • Depending on healing, I found I needed the bathroom more after eating certain foods
  • I found that sugary foods went through me quicker
  • Sometimes eating multiple smaller meals worked better than three big meals
  • I used fiber supplements to help thicken the stool
  • I avoided eating late in the day, so I didn’t need to go to the bathroom at night
  • Note: It is possible to still get blockages when you have a J-pouch. To help prevent this, I made sure to chew my food thoroughly, and if I noticed that it felt like I was getting a blockage I would drink lots of water or Coke/Pepsi and restrict my eating until the blockage passed

Medications & Supplements

  • I use anti-diarrhea medication before bed, which helped me not need to use the bathroom at night
  • I also take a probiotic because I find it helps me when I have a stomachache or I just ate something that makes me need to go to the bathroom more


  • Pouchitis is common, so don’t freak out if you get it. Symptoms can feel kinda like colitis symptoms
  • Sometimes your doctor may recommend a scope of the pouch to confirm this is pouchitis
  • When I developed pouchitis, I felt nauseous, had no appetite, had a stomachache all the time, had no energy or motivation to get out of bed, and was extremely tired
  • I have only had pouchitis once, but you can get it multiple times
  • To treat my pouchitis, I took medication for three weeks, which my doctor prescribed to me (the length of time on the medication can vary)
  • As I said before, I take a probiotic to help increase the good bacteria in my gut and help fight off infection

 Using the Bathroom with a J-pouch

  • I had urges, then tried to go to the bathroom and nothing would happen. We called my doctor, who recommended taking more anti-diarrhea pills. If you’re having a similar issue, talk to your doctor and come up with a plan together
  • Just know, it will take time to have a “normal” bowel movement

School & Travel with a J-pouch

  • If you attend in-person school, plan ahead for needing to use the bathroom multiple times a day. If you don't have them already, talk to your school about setting up accommodations (here are some IBD Accommodations resources that can help)
  • Traveling with a J-pouch takes some extra planning. For example, if I were going on a two hour car ride, I would stop eating an hour before leaving and take some anti-diarrhea pills

Remember! Everyone is different. If you read this post and find yourself thinking "Wow! Anti-diarrhea pills are a great idea!" or "I'm going to start probiotics!" or "Uh oh! I think I might have pouchitis." the first thing you should do is call your doctor. That way you can make a plan together that works for you! I hope this helped you feel more comfortable and informed about what to expect after surgery and with a new J-pouch, and I'd be interested to hear about your experiences (so leave a comment below).

- Hannah


Sign up to Stay #InTheLOOP and never miss a post! 
Read more posts by Hannah on the blog >>
The Accommodations Toolkit is a free, 23-page resource co-developed by the Patient Advisory Council and the ICN Community, which can help you understand, set-up and access accommodations for school, work and life.
Should I have IBD surgery? is a free, interactive webtool that can help patients with IBD understand their choices and think about what matters most to them when considering surgery.
The Ostomy Toolkit was designed for patients, by patients. It's free and includes tips, tricks and personal stories about school, travel, supplies, playing sports, clothing choices, and how to tell friends. It's an extraordinary tool to help lessen fears about ostomy surgery and life with an ostomy, and to promote awareness and understanding.
Note: if you are seeking additional information about J-pouches, ostomies and takedown surgery, and the role they may play in your IBD care, we recommend continuing the conversation with your IBD care team.

Built by Veracity Media on NationBuilder