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Something strange is going on with my system. I have a jpouch since 1988 and had a few bouts with extreme pouchitis with symptons of high frequency and some night leakage.  Cipro always took care of the situation.  I had a pouchoscomy in July and the pouch looked not too bad.   

However, of late, I feel full but cannot go often.  Stools are well formed but I have to work at elimination.  Some leakage at night.  Will get up and try to go but cannot and then will have some leakage a few hours later.  Do not have any pain, but do feel full and do feel the pouch is not clearing properly.  Have started on cipro and so far nothing much has changed even though 3 days have passed and usually cipro works quickly.  Have notified my GI docter but so far, we are mystified.  Has anybody had a sudden change like this?  Am a bit worried that the pouch is just wearing out.  I still have GI sounds so at least that is good.

Looking forward to your input.   Mary

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A few different things can interfere with pouch emptying without causing pain. “Well formed” stools aren’t the ideal target for most J-pouchers, and they are harder to eject than the pudding/applesauce consistency that seems to work best for many. I’m guessing, though, that you’ve had formed stools for a long time and the emptying problem is something new. Even so, softer stools might work better if, for example, you’ve developed a stricture. Another possible obstacle to emptying would be pouch prolapse, best diagnosed with a defecogram. There are other, less common things to consider, too. There’s a chance of a functional problem, but your body is very experienced at pouch emptying and seems unlikely to have forgotten how.

The first home remedy I’d try is bumping up fluid intake, at least to see if the emptying problem changes or goes away when the stool is softer. I’d also schedule a pouchoscopy, mainly to look for a stricture or something unexpected.

Good luck!

If you have had the pouch 32 years with one or two isolated incidents of pouchitis and a recent scope shows things were fine, it would be extremely premature to consider biologics, although it sounds like you may be having a pouchitis issue. Scott's suggests on hydration and perhaps Metamucil sound like a prudent first step as you may be getting dehydrated for some reason. If the issue persists other antibiotics besides Cipro should probably be attempted. I would also suggest you may also want to try Pepto Bismol in conjunction with proper hydration as it will kill all the bacteria that may be causing any pouchitis issue, although it's not something you should use chronically in lieu of antibiotics. And it can be tried alone or between antibiotic dosages (at least 2 hours apart).

Last edited by CTBarrister

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