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In medicine, the ileal pouch-anal anastomosis (IPAA), also known as an ileo-anal pouch, restorative proctocolectomy, ileal-anal pullthrough, or sometimes referred to as a j-pouch, s-pouch, w-pouch or an internal pouch (or Kock pouch), is a surgically constructed internal reservoir; usually situated near where the rectum would normally be. It is formed by folding loops of small intestine (the ileum) back on themselves and stitching or stapling them together. The internal walls are then removed thus forming a reservoir. The reservoir is then stitched or stapled into the perineum where the rectum was. The procedure retains or restores functionality of the anus with stools passed under voluntary control of the patient. ==Reasons for pouch construction== Ileo-anal pouches are constructed for people who have had their large intestine surgically removed due to disease or injury. Diseases and conditions of the large intestine which may require surgical removal include: * Ulcerative colitis * Crohn's disease * Familial adenomatous polyposis * Colon cancer * Toxic megacolon There is debate about whether patients suffering from Crohn's disease are suitable candidates for an ileo-anal pouch due to the risk of the disease occurring in the pouch, which could make matters even worse. An alternative to an ileo-anal pouch is an ileostomy. Ulcerative colitis is ''cured'' if the large intestine is removed and the patient has the pouch created, but Crohn's disease often inflames the pouch and the adjacent small intestine after this surgery is performed. When this happens, it can result in the return of symptoms and dysfunction of the pouch. In some cases where the pouch was formed to manage colitis, inflammation can return to the pouch in a similar way to the original inflammation in the colon. This is known as pouchitis. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Ileo-anal pouch」の詳細全文を読む スポンサード リンク
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