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Hi John

You do not mention if you are actually passing stool or not, so there could be a couple of things going on. I'll run down the list.

Most likely:

- Having a sensation that you are not fully emptying your pouch is one of the telltale signs of pouchitis.  Other common symptoms of pouchitis include increased frequency, watery stool, a general feeling of malaise, and occasional nighttime leakage. Symptoms of more severe pouchitis may include a low grade fever, lower back/tailbone pain, and sometimes bleeding. If you suspect pouchitis, you will need a course of treatment with antibiotics, usually 10-14 days of cipro and/or flagyl. Call your GI or surgeon, as often you do not need to be examined, as antibiotics are often prescribed based on symptoms alone.  

- A stricture, or narrowing of the pouch at any point, can make it difficult for stool to pass, which can result in straining and incomplete emptying.  Stricture can be confirmed on digital exam, and you may need to be dilated. Most often, that can be done right in the doctor's office. As, stool softeners or small amounts of prune or grape juice taken throughout the day may help thin the stool and make it easier to pass if you do have a stricture.

- Cuffitis - this is an inflammation (basically UC) in the retained rectal cuff. Cuffitis has many of the symptoms common to pouchitis, so sometimes they can be difficult to differentiate, however cuffitis is usually also associated with  bleeding more often than not. 

Of note, it's partial to have stricture AND pouchitis and/or cuffits at the same time, and you need to be treated for both. 

Less likely

- Partial obstruction. You may have a partial obstruction making stool hard to pass, however this is almost invariably accompanied by wave-like cramping, bloating, and nausea with or without vomiting. In addition, you may pass smaller amounts of very watery stool.  However, you don't mention any of the symptoms typical of obstruction, so this is probably not your issue.

Other issues may include SIBO or a yeast infection. 

You will need to be assessed and treated for any of the above. Give you GI or surgeon a call. There is no reason to be suffering as you are if you have a treatable problem. 

 

Last edited by Spooky

I am sort of confused. If your doctor told you that you had a yeast infection, it does not make sense that he would recommend antibiotics (unless you are leaving something out, such as you have pouchitis too and the yeast infection was just on the skin). If you have a yeast pouchitis, he would have prescribed an antifungal, like Diflucan. 

If you needed antibiotics then, you probably need them more now. Pouchitis doe not just go away.

Jan

Sounds to me like you need a prescription oral antifungal to help get back on track. The supplements may help with the symptoms, but if you have a fungal pouchitis, it should be treated aggressively. Supplements are intended for maintenance, not cures. I recommend calling your doctor before things get too serious.

Jan

 

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