What pouch function actually looks like

One expectation comes before any of the numbers: this will be erratic at the start. Soon after the ileostomy is reversed, when the pouch starts to function, your body needs to learn how to interpret when the pouch is filling and when you need to defecate. There is normally a delay of a few days before bowel content enters the pouch at all.

In those first days it is not uncommon for faeces to be very liquid and frequent, with little notice to reach the toilet. Control can be difficult and you may experience some leakage of stool. As diet returns to normal over the following days, output begins to thicken, frequency decreases and control improves.

The two figures

The surgeons who perform the operation put it at 5 to 7 times per day, with a need to get up once at night, and improvement continuing over 12 to 24 months. The nursing guidance describes six to twelve months before the pouch settles into a routine, after which most people go to the toilet four to six times during the day and possibly once or more at night — and adds that pouch function continues to improve for up to eighteen months following surgery.

What else changes

• You should be able to distinguish between wind and stool in your pouch.
• You may experience some incontinence at first, particularly at night, and it can take time to get this under control.
• You would normally have complete control over your pouch. Where frequency stays high, a surgeon may start loperamide (Imodium) or codeine to slow things down.
• Recovery is usually straightforward but you may feel very tired at times. Because surgery is often carried out in two or even three stages, it may take more than a year to complete.

The result is not oversold anywhere, and the framing is worth carrying: the pouch operation will not restore your bowel function to the way it was before you became ill, but many people find it an acceptable alternative to a permanent ileostomy.

How long the whole thing takes

It can take several months before you feel the full benefit of the operation, and six to twelve months before the pouch settles into a routine. Because pouch surgery is often carried out in two or even three stages, it may take more than a year to complete — and you will need the support of your family, friends and employers through it.

What nobody will promise is a number for you specifically. Recovery from this procedure is individual and usually straightforward — although you may feel very tired at times.