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There are a number of reasons the J pouch anal anastomosis fails.

I would say the most common fault would be when the patient is in pain from constant pouchitis, an inflamed condition of the pouch which does not abate over a course of time and the pouch owner choses to have the pouch excised and return to an Ileostomy. Other reasons include stricture of the join at the anastomosis which closes off the exit and difficulty in evacuating faeces occurs.

Perforation is another pouch failure condition, the stitched seam can break open due to force or trauma, the bowel contents then enter the peritonium, an emergency laparotomy is necessary to rectify the condition.

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Q: What is the cause of a j-pouch failure with ileal pouch anal anastomosis?
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