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Hello all,

I'm now 24 years old and have had my J-pouch for 9 weeks (takedown was unexpected bday present!). I am finally feeling so much better! But I've recently been diagnosed with anemia that has not gotten any better, and I'll need iron infusions.

My jpouch is functioning quite well and I'm so grateful to be down to fewer bowel movements, but I notice that my stool is mixed with blood about 1-2 times a day.  There is no pain, urgency, or frequency, like with UC, and the stool looks sludgey and normal but just blood-tinged or orange-tinged.

I would truly appreciate it if anyone could contribute reasons as to why they might have experienced bleeding apart from pouchitis, and if it got better? At my 6 weeks visit, my surgeon said that we should just wait and see since I'm not in physical pain and that there is a possibility there could still be bleeding or irritation somewhere near the old ileostomy or pouch sites. 

Thanks so much. 

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At 9 weeks post surgery the bleeding *might* be mostly unrelated to the anemia - most of the lost blood could be related to the surgery, and perhaps the iron infusion will fix you right up. Painless bleeding has a good chance of being caused by hemorrhoids - that would be my first guess. It's less likely to be cuffitis, I think, which usually causes symptoms, though it could possibly be a small ulcer. There is essentially no chance that it's cancer. If it started at takedown it could possibly be a tiny blood vessel disrupted at surgery - that would need to be fixed.

It's been over a decade since I had my surgeries, so my memory is foggy...! but I do recall having bleeding for a substantial amount of time post-surgery. It sort of dwindled away over time, going from daily, to occasional, to not at all. No one seemed overly concerned about it and it resolved on it's own after a couple of months. My surgeon did say it could be remnants of surgical things, and my GI even suggested it could be the rectal cuff finally calming down from disease. Either way, it went away. 9 weeks post surgery isn't very long for these major surgeries--perhaps just keep your specialists in the loop for your own peace of mind and to monitor your iron? I think my iron levels took 6 months to get back to normal after years of UC bleeding/all the surgery. 

I have had my take down suregy 2 months after j pouch construction and I am almost 2 weeks into after take down . My number of BMs are pretty normal . The only problem I have is that I get blood in stool sometimes . Sometimes it's just streaking but I got big drops of bright red blood today which is freaking me out . Also I feel pain in my rectal area and Labias if I walk or stand for more than 10 minutes . It gets better upon sitting . My surgeon and Doctor Doesn't know the reason for it . Did anyone ever feel pressure pain like me and it's been going on since my second surgery . 

Hello everyone - thanks so much for your responses! If anyone else encounters this issue, please feel free to add your much appreciated insight to the thread. 

Scott F - I really appreciate that differential - I will try and ask about those possibilities at my next appt! It is honestly so strange, as I will go 5 BMs without blood and normal appearance, and then maybe 1-2 with an orange tint and reddish pieces (that look like tiny shards of carrot almost) floating around that look like bloody remnants. I have no idea what sort of bleeding pattern this is. Last time I spoke to my surgeon, he said that it is normal for some patients to have continued bleeding for a while. *shrug*

Duck 11 - Thanks for the calming perspective! I can't believe it took that long to heal you iron levels - did you get them up from simple oral supplementation? I am wondering if I absorb iron with my jpouch.

Nish123 - How has your blood been - have you been able to ask your doctor? I am getting the impression that some blood, especially so soon after surgery, happens to people, unless it is quite a bit. Is your stool so solid that you can have streaking?

I am male, so maybe a female poster may be able to help answer your other concern better, but I do not feel too much noticeable pelvic pressure from my pouch myself. I hope that you can figure this out or hear from others that may have felt that. 

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