Table 1.

Preoperative pathway for patients undergoing ileoanal pouch surgery

1	Outpatient clinic consultation in dedicated pouch clinic with colorectal surgeon, gastroenterologist, stoma/pouch nurse.	a. Give written information—dedicated leaflet developed b. Counselling on pouch function. c. Counselling on stoma formation and function with written information and stoma siting with stoma nurses (if no stoma already present). d. Offer peer to peer counselling with our group of j-pouch patients who have volunteered. e. Offer follow-up appointment if decision cannot be reached on the day. f. Give pouch service contact details and dedicated email address.
2	Essential requirements to proceed to pouch surgery:	a. IBD MDT discussion. b. Young adult transition MDT discussion (if paediatric/young adolescents patients). c. Histopathology review of previous specimen(s). d. Small bowel assessment (MRI small bowel or capsule endoscopy). e. Review of current medical treatment.
3	Planning of surgery (depending on performance and nutritional status, current medical treatment)	a. Two stages (proctocolectomy and j-pouch with loop ileostomy). b. Three stages (subtotal colectomy with end ileostomy, proctectomy and pouch, stoma reversal).
4	Collect patient-reported outcome measures (PROMs)	a. Quality of life (short IBD questionnaire). b. Pouch clinic feedback form (dedicated form developed from NHS friends and family test). c. Urogenital function: International Index of Erectile Function-5 and International prostate Symptom Score for Male patients; Short Female Sexual Function index-6 and International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules for Female patients. d. Body Image: Appearance Anxiety Inventory. e. Fatigue: Work Productivity and Activity Impairment Questionnaire. f. Dedicated online platform to facilitate collection of PROMs.

IBD, inflammatory bowel disease; MDT, multidisciplinary team; NHS, National Health Service.