Hi All. Long time lurker...

I'm 6 weeks post takedown. After about 2 weeks I noticed myself straining very hard to empty my pouch. Surgeon noted that I had a 'tight' anastomosis (ie stricture) and suggested meds/fibre to bulk the stool and get the area to stretch on its own.

Of course that remedy failed and 3 weeks later I was in for a dilation under anaesthesia. For 2 days after that it did seem a lot better, I was passing anything without having to push very hard at all. But now, just a week after the procedure, it seems like it's just how it was before. Lots of tenesmus and I have to push real hard to fully empty (and even then, I often leave the bathroom still feeling like I haven't emptied). I've resorted to drinking prune juice regularly to keep everything moving along.

My question is, is it common for the stricture to re-form this soon after a dilation, or is there a chance what I'm experiencing now is actually due to something else? My Surgeon said I can 'maintain' the opening myself with a lubed-up index finger. I do this every day and can get my knuckle past the 'ridge' where the connection is, so I know it hasn't fully closed up. Surgeon also said (during the examination) that the pouch itself looks great - no pouch/cuffitis happening.

Original Post
6-weeks post-takedown, it could be recurrence of the stricture. However, since you are so early in the healing / recovery process, and you can verify the opening is still index finger-wide, it could simply be your pouch healing up and re-adjusting to things. Pouchitis can cause difficulties emptying as well, and it is not uncommon to have symptoms 6-weeks post takedown (however, most surgeons will not consider treating it as such at this early point after takedown).

My advice: continue self-dilation, and see if you can't adjust your gut flora with some good yogurts or probiotics to see if that helps. I think your surgeon is optimistic if he thinks metamucil will bulk your stool enough to stretch the anastomosis. Even when I have formed stool, I don't think it would have the ability to stretch anastomosis tissue.


Add Reply

Likes (0)
Copyright © 2019 The J-Pouch Group. All rights reserved.