The ileoanal reservoir, or ileal pouch-anal anastomosis, is a relatively new, innovative surgical approach offering normal sphincter preservation to clients with familial adenomatous polyposis and ulcerative colitis. In most patients, the ileal pouch-anal anastomosis is performed in two stages. In stage one, the ET nurse must address such patient-education issues as an understanding of the surgical procedure, care of the temporary ileostomy, diet and electrolyte balance, care of the perirectal skin, and the restrengthening of bowel control. Stage two ET nursing interventions focus on perianal skin care, use of medications, sphincter reeducation, and prompt recognition of complications. Written instructions offer the best method of providing crucial information succinctly. Patients require significant physical and emotional support throughout the potentially complex, long-term course until an optimal steady state is achieved.