Skip to main content

Reply to "Pouch leaks might be from SSRI anti-depressants and other drugs"

The symptoms I had, as noted above, were both lower right-side pain (around the bottom of the pouch)  and serious random leaking of output. My doctor at first thought it was adhesions, but that could not explain the leaking. Shavon, you didn't mention leaking so this could be a possibility.

If you're going to try tapering, its really important to do so very slowly and gradually. I am super-sensitive to these drugs and was on a small dose of Paxil so I asked my doctor for a "suspension" formula (liquid form) and used a syringe (no needle, ask your pharmacist for one with fractions of an mL and do a mg-to-mL conversion) to smooth out the taper. I don't know whether Prozac comes in suspension form but you can also get some empty gelatin capsules and tap half the contents of a pill into an empty one to halve a dose. Tapering slowly is really important -- you don't want to trigger more depression and I found my symptoms subsiding as I reduced the dose.

Some surgeons, including Dr Pokala Kiran, have heard about this problem with SSRIs but there is still nothing about it in the medical literature. My then-doctors Jeff Milsom and Toyooki Sonoda had never heard of it and poo-poo'd me when I told them what I'd concluded -- and I am a real-live neuroscientist with a PhD and fat credentials and everything -- so if your doctors don't "get" that this may be the problem, tell them the following theory behind the findings:  its well-established that  the enteric nervous system (GI, gut) expresses lots of serotonin receptors. As SSRIs increase the availability of serotonin in both the central AND enteric nervous system, the neurons in our "displaced" intestinal tissue are getting signals which no longer make sense, given that the tissue is now pouch and valve. The leaking and the pain occur where muscle fibers are getting signals to contract and release as a function of gut motility which is no longer appropriate given their current location.

I'm definitely feeling the loss that I can't take SSRIs -- they were the most effective drug for me and I can't even handle a tiny dose. The only antidepressant that doesn't affect the serotonin system is Wellbutrin, and for me Wellbutrin has helped when I needed it but not as much as the SSRIs. So its worth exhausting other possibilities about any pain and leaking so that SSRIs remain an option if you need them.

Copyright © 2019 The J-Pouch Group. All rights reserved.
×
×
×
×