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At my wits end with Stomach and Anal Pain! Advise Please..

I am recapping my issues below - I welcome any experiences or suggestions on what to do from here - besides getting a second opinion which I am going to do.  Are there are medications?  IBD type drugs? Diet etc.  I am not able to sleep and stomach and anal discomfort is bad.

  • Diagnosed UC 11 years ago, J pouch surgery 8 years ago
  • Chronic Pouchitis started relatively early after surgery, antibiotic dependent has been on Cipro for approx. 7-8 years – functioned pretty well
  • Recently has been having a lot stomach pain, nighttime accidents, and problems/pain in anal area (he thought it was hemorrhoids – large lump on anus).
  • Dr. added Metronidazole on top of Cipro to try and address stomach issues.  Took for a week – maybe helped but was getting very nauseous. Stopped the Metronidazole.
  • For anal pain, Dr. initially treated for hemorrhoids with topical ointments – over email.  Lump wasn’t observed in office (by the time he got into see Dr. the lump had subsided) pain was still there but not as severe.
  • 2/15 Dr ordered MRI to evaluate anal issues.  MRI indicated small fistula and one branch.
  • 2/18 had a pouch scope (it had been three years since last one) and was supposed to get a seton or surgery for fistula
  • Surgeon did procedures and said pouch looked good.  No signs of Crohn’s or inflammation – waiting on biopsies.  However, he was unable to find opening of fistula so did not do any surgical procedure. Despite this, there was a lot of blood post procedure.
  • Feeling very poor (worse since having the scope).  Stomach pain is daily on and off all day and seems worse at night.  Also having nighttime accidents and anal pain.  From his perspective, both seem worse after having been scoped.
  • Stool frequency isn’t excessive 5-6 per day consistency somewhat controlled by food (not always diarrhea etc.)
  • Nausea on and off for several weeks
  • Continue to have extreme nighttime sweating – this has been going on for years
  • Stomach pain is on and off high and affecting ability to function normally
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