How Does the JPouch Work

The common understanding of the colon pouch as a neorectum taking over the reservoir function previously performed by the natural rectum cannot on its own explain its functional results. The data discussed before suggest that pouch function is a complex physiological process involving different mechanisms:

• Function of reservoir: faecal contents distend the pouch as a reservoir which increases its capacitance and improves its compliance [38].

• Function of "pressure sump": the pouch is able to dissipate its intraluminal pressure before the MRP of anal canal and the sphincter mechanism of continence are overcome [17].

• Function of motility modification: the functional principle of the colonic J-pouch may be also related to decreased peristaltic waves and motility within the pouch or even to the creation of anisoperistalsis in one limb of the pouch [57, 58].

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