hello I have had my jpouch since 2008- all has gone well until about 3 weeks ago. Now every meal about 30 minutes after I eat  gas pains, urgency and very watery stools, stay on toilet on and off for about  an hour after I eat. Is this pouchitis symptoms? Or any other thoughts?  I have an appt with a gastro mid August, first available. This group was a life saver after my surgery 11 years ago, thanks to all. 

Original Post

It could be pouchitis, though it doesn’t sound classic to me. Some GI infections, like giardiasis, can last for three weeks, but most should have cleared up by now. When was your last pouchoscopy? I’m guessing that your GI won’t be ready to perform one at your August appointment, but perhaps they’d agree to put you on the schedule for one, if you’re overdue.

Sounds more like a a diet issue, something is causing gas to build which is causing the urgency. Pouchitis you wouldn't just have issues after eating.

Not to say it couldn't be pouchitis but I would suggest looking into your diet. I had to go through the low fodmap diet to figure out what causes me gas as I was having similar issues to you.

Texasgal posted:

....... I have never had a pouchoscopy . I will inquire when I see Dr about scheduling procedure.....

11 years since surgery and never had a pouchoscopy? Maybe you've had what was called a "flexible sigmoidoscopy"? It's hard to imagine that your surgeon hasn't been seeing you for regular follow-ups.

If a pouch is functioning optimally it’s understandably hard for folks to spend the time, money, and hassle to see a doctor about something that’s working fine. Since most problems declare themselves with symptoms, the biggest issues I see with non-care are 1) not having a current relationship with a surgeon or gastroenterologist when you do need help, 2) problems being accepted instead of diagnosed/treated, and 3) symptoms creeping up on you so slowly that you don’t realize you need help. In defense of not seeing doctors for non-problems, I’d argue that regular visits for non-problems is a horribly inefficient way to ensure access to care when you do need it. My solution has been choosing an internist for my general health who is also a gastroenterologist. This works in part because I’m old and broken enough to have various non-GI reasons to need regular medical care, and because my GI likes to do general internal medicine.

Folks who had a colectomy for cancer or dysplasia are taking a bigger risk if they forego regular pouchoscopies, but I’m neither surprised nor particularly worried about someone who lives their life happily without medical interventions.

Scott and Jimi- thank you so much for  replies sooo helpful.  Forgive my earlier incorrect information,  I now realize  I did have in pouchoscopy 2012. I believe my surgeon said what you mention Scott,  Unless I start having issues he said no need to return. Scott  Your post was comforting to me not to freak out over no pouchoscopy in 7 years if no issues, I am way over paranoid most days...thank you, eased my anxiety. With that being said Jimi your post prompted me to email my surgeon and ask with current symptoms should I schedule a pouchoscopy? As always this board provides so much more help/comfort/information than any Dr has ever give me Scott very interesting you have located an internist/gastro combination I think that is awesome...I may try to locate same type physician moving forward.  I already had annual appt. scheduled with my gastroenterologist early Aug. so I will wait to see if surgeon recommends I see gastro first- then determine to make pouchoscoy appt with surgeon or make appt. now. I may have follow up questions once I hear from my surgeon. Again thank you both for replies.         

Some people are followed by their surgeons forever. I have had all of my follow-up care from gastroenterologists, and never saw my surgeon again. I sent him the occasional grateful email, though.

All gastroenterologists have had the training of internists. Only some are willing to practice general internal medicine, though.


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