Blood in stool after jpouch takedown

I'm looking for a little advice here.

My jpouch was created in August and my takedown was about 4 and a half weeks ago. Overall I'm not doing bad. I'm still trying to figure things out but overall I'm pretty happy with my progress. A couple weeks ago I was having a hard time emptying so I was straining a lot. I started noticing little traces of blood on the toilet paper after I went but only if I strained real hard and not even every time I strained real hard.

I met with my surgeon for a check up last wed and she told me not to strain to much and just keep an eye on the bleeding.

So tonight I went to the bathroom and there was quite a bit of blood. I could see it in the bowl and on the toilet paper. I don't have any symptoms of anything really. I have no problem going, no problem passing gas, no leakage.

Should I be worried or should I just attribute it to a new jpouch and trying to figure it out still. Obviously if I keep bleeding all the time I have an issue but is it common to see blood every now and again in a new jpouch?

12/26/209:00 PM

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Jan DollarModerator, RN, retired

Ileal tissue bleeds pretty easily, so the bleeding could be from your straining. Perhaps you have some restriction from your ostomy takedown and straining against it is causing trauma. If you have some retained rectal tissue, that could be bleeding. If it was something more serious like a ruptured blood vessel the bleeding would be more brisk and heavy. If it was acute cuffitis, you would have other symptoms eventually (like pouchitis).

Since you have followed up with the surgeon you should be fine with your current watchful waiting. Maybe back off on the roughage and go back to your more easily digested post op diet, focusing on a high fluid intake and low fiber. This should be self limiting and temporary.

Jan