An update, J-Pouch for 20+ years, chronic Pouchitis, Cuffitis and pain. Like most, some days are tolerable others not so much. The last few months have been the most challenging times I can remember. recently culminating in a first Bowel Obstruction (though it has been speculated that this is not new only that the current episode did not resolved itself as others likely did). After some diagnostics including scopes, biopsies, CT and Ultrasound it seems that I now have Crohn's disease at the terminal ileum right above/at the anastomosis to the pouch. My GI Docs say they are seeing more and more of this situation; patients who present initially with UC then have J-Pouch surgery only to develop Crohn's at the terminal ileum some years later.
So, the terminal ileum has thickened walls, moderate stricturing, inflammation and mild infection. I was told by a J-Pouch friend that these strictures generally do not resolve, don't improve with or without meds and generally follow a predictable course that ends in surgery -bowel resection.
Q: Do these Crohn's strictures eventually require surgery?
Q: Do these strictures reappear in the bowel after surgery?
I'm currently taking Azithioprine 250mg/day, and 10mg Prednisone. I continue to have symptoms of a partial bowel obstruction, fever like, weakness, bloat, gas, difficult swallowing, liquid stool with traces of blood and a general feeling of total crap.
Any thoughts appreciated.