I'm going to try to post this again with a different header as i didn't receive any responses on my last one....

I've had 22 partial bowel obstructions the past year, lots of time in hospital. I finally saw a surgeon who might have answers and she thinks my J pouch is failing (I've had it 20 years with very little problem until the past 19 months). She thinks it isn't capable of pushing things through anymore, it sounds to me like it's kind of "dead" for lack of better words, and this is causing obstructions in my small bowel just above it from a lack of peristalsis. I had a gastrograffin test and the gastrograffin just stopped right at my pouch inlet for like 7 hours but there was nothing physically blocking it. I can't find any info. on this anywhere so was curious if anyone else has this? She suggested I try emptying my j pouch from the bottom end  with a catheter and I know some on here do that-did it help with emptying/pain? Would enemas help or make it worse and just trap liquid in my malfunctioning pouch?

I'm going for a defecography in 2 weeks, and she said if the catheter trick doesn't work I'll need my J pouch taken out and have to have a permanent ileostomy, big surgeries..... Please help! Thanks.

Original Post

I’ve had this issue after having my pouch for 20 years. I had several surgeries to remove distended sections of bowel. I still had problems emptying and the vicious cycle started over again. I just couldn’t empty out. Then I finally had a surgeon willing to work with me and I started to use the catheter and would irrigate out my jpouch. In addition, my surgeon does Botox injections because I had a bit of narrowing down there and it helps relax the muscles. I’ve been doing this for the last 9 years. So depending on what your tests show and what your surgeon is willing to do the catheter can be a God send. Hope this helps! 

Kc1126-thank you! This is just the info. I was looking for-it sounds just like my problem. I haven’t gotten any further info. From her about the catheter-how does it work? Is it sort of like having an enema multiple times per day? I’m curious how many times per day you need to do it, and if it got rid of all your blockage-like pain.  I’m tired of being sick and in pain can u eat most things or can the catheter get plugged with roughage fiber? thanks for any info/details you can share. 

Sometimes pouch prolapse gets misdiagnosed as functional pouch obstruction. The proper test to check for pouch prolapse is a defecogram. It can be reasonable to choose catheter emptying over a surgical repair, but only if the correct surgery is properly understood.

Duck11, Glad I could help a little! It's a very specific issue and you'll know more after the defecography and scope. It's not a perfect system but over the years it's become easier to use. I've figured out a routine that works for me. Now is probably not the best time to ask me because I'm having some unexplained pain...but...normally I use it between 3-6 times a day and I don't have any pain. Occasionally some gas pain but nothing terrible. It's kind of like using an enema but the catheter is a little wider. It takes some getting used to. I irrigate with water and a bulb syringe if it gets clogged. Sometime I have to take it out and irrigate it out and reinsert. Not as quick as just going to the bathroom but I've become fairly quick at it.

I should preface all of this by saying I went through a lot to get to this point. I had 2 ileostomies leading up to this. One was for a full year to give the bowel and pouch a rest as they were very distended from not being able to empty on my own. Hopefully, you're not to that point. Give the catheter a try instead of the enema. If you can insert it and get the stool out then I would think that would help with the pain. It's been a lifesaver for me. I also take Miralax everyday to keep things loose which makes using the catheter easier. Feel free to ask more questions. I know when I looked for info on this specific problem I couldn't find anything either. I wish you luck!

Winter wish the article and website is great-thank you! 
Scott- I am going for a defogram and pouch scope so hopefully that will help.

KC1126- this is very helpful-thank you so much! If my surgeon says to go ahead, I may bug you with more questions

I am just so astounded with how long it has taken anyone to figure this out. I have seen upwards of 5 colorectal surgeons the past 18 months via being admitted from the ER for bowel obstructions and they all told me it was from adhesions and sent me on my merry way once the Ng tube cleared me up. This is the first surgeon who said “hang on, something else is going on here”. I almost had a laparotomy-I was in the little blue surgery hat getting rolled to the surgery when she said ‘stop-this isn’t a mechanical obstruction’. If she hadn’t been there for a second opinion from her colleague I’d be recovering from surgery for nothing right now. I’m in a big city, so it’s not that there isn’t access to good hospitals here. Anyway, thanks all for your advice, the clouds are finally! Parting a bit from 18 months of awfulness. 

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