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Hello all, I'm looking for advice and information regarding pregnancy / delivery with a jpouch. I'm starting ivf in June and scared to death of the unknown of pregnancy. I have fap and had my j-pouch surgery in 2002. I've never had any issues in the past 12 years- just normal function.(been very blessed) my questions are
Does pregnancy effect your pouch?
C-section effect the function of your pouch?
I'm just hyper of having my pouch get wrecked.. I want a baby so bad but afraid that pregnancy will destroy my pouch.
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Other than increased frequency in the 3rd trimester as your baby will put more pressure on your pouch, pregnancy shouldn't affect your pouch or it's function at all. C-section also shouldn't impact your pouch in any way. Most women choose to go that route since there is concern for long-term weakness to sphincter muscles from vaginal deliveries (that would be the same for probably any woman, but more of a concern for women with j-pouches). I had my second child vaginally with no problems, but again, it's only been 3 years. Those problems can show up much farther down the road, but it could also not be a problem at all. Conceiving is usually the most difficult part...once you are there, pregnancy shouldn't be all that different. I've been pregnant with and without a pouch and other than the increased frequency for the last 3 months, they were pretty similar.
I have FAP and got my jpouch in 2002 as well. I went through fertility treatment but did not do IVF. Nothing we tried worked. I read about Metformin and baby aspirin and we got pregnant on both of those drugs several years later.

For the entire pregnancy, I had stool leakage. I had to wear panty liners 24/7. A few times, I woke up in the middle of the night laying in stool from my pouch leaking in the middle of the night.

I had a scheduled c-section. That part went just fine. I delivered at 39 weeks. After my c-section, I got an ilius and ended up with an NG tube.

After all I went through, it was well worth it. I have a healthy 2 1/2 yr old girl now.

I have not had any unusual problems with my j-pouch since the c-section.

First of all, if your OB says it's okay, try natural delivery! My pouch is 10 years old and I've had two beautiful babies and am expecting number 3 this spring (that's 3 kids since 2014). 

My first pregnancy I had a high risk OB and delivered at a hospital that had a GI team on deck if an emergency were to occur (which is rare). There were no issues so my second I visited my high risk OB a couple times but saw a regularly OB and delighted at a regular hospital. With this one I have a midwife and will deliver at the same hospital. Just err on the side of caution until you know how your body handles delivery.

I DID find that following pregnancy, if I have pouchitis I can have incontience (just at night....maybe every 3 nights IF I CURRENTLY HAVE A BOUT OF POUCHITIS). Otherwise, no issues! 

I really didn't notice anything different with my pouch and output in pregnancy, but I also have relatively easy ones.

I hope this helps and I wish you the very best!!

Lydia

Just posting here in case anyone lurks in the further. I had severe morning sickness in early pregnancy that manifested as pretty severe diarrhea. I lost 10 pounds (that I didn't have) and worked around the clock to keep hydration up. Luckily I avoided a hospital admission and thanks to ensure + calories I have now gained 5 pounds back (now happily in second tri). I continue to manage ongoing struggles to maintain my weight so I don't lose and to keep hydrated. 

I've also experienced a lot of stretching and pulling from my scar tissue/adhesions breaking up. I'm putting that here because it took me awhile to learn that this was not a part of "normal" early pregnancy. 

That being said I love being pregnant and am so grateful for IVF technology. I've been reading the literature and having dialogue with my active physicians who believe that a c-section is the best approach for delivery. 

I am always available if anyone has any questions (keeping in mind I haven't experienced 3rd tri/ delivery yet)

 

Thanks for sharing! I had my first trimester ultrasound today and it went well. �� My surgeon has told me multiple times that his patients who have regular deliveries do just fine. I would still like to learn more before making the c-section/natural delivery call. One thing I would be worried about is pushing...I never push when using the bathroom because I don't want to hurt the j pouch in any way. I feel like I would be so aware of not wanting to hurt the pouch that I would be inhibited from pushing out a baby. Is that something to be worried about?

Generally speaking, the concerns about vaginal delivery have been for the long term health and strength of the sphincter muscle, not any immediate dangers or complications.  Since vaginal deliveries can impact the strength and tone of the sphincter in woman with NO bowel issues, the concern is that with a j-pouch the function of that muscle is more important than for those without and weakening it may cause continence issues later on.  Unfortunately, no way to know if this will affect you or not, or how likely it is.  So you have to determine with your doctors the risk, and you need to decide how you would feel about it if this did become an issue.

One other thing to consider though.  I had a perm ileo at the time I had my babies.  My high risk OB was fine with me trying vaginal delivery (sphincter not an issue for me) but he did caution that if he needed to do an emergency c section, he would not be able to take any special care with my bowels.  By doing a planned c-section, he was able to be more conscious of what he was doing since it wasn't an emergency situation.  I opted for c-sections mostly because of this and because dr felt unless I had small babies (under 7lbs) a vaginal delivery would be very difficult for me.

My "babies" are now 11 and 8 1/2 :-)

 

Hi there,

I'm similar to Mrs. H, my pouch is about 10 years old. I had my daughter about 2 years ago and I was surprised to find that I felt a little better than normal "pouch wise" while pregnant. I found the pregnancy hormones slowed down my pouch a bit which was a nice break. My doctor was very optimistic about a vaginal delivery so I attempted this route and it went great! Had a bit of tearing as most women do with their first but no problems with my pouch. For me personally, I didn't experience anything out of the norm pouch wise post partum. I am now 30 weeks pregnant with second baby and again my doctors are optimistic about a vaginal delivery. So we shall see how it goes! As I write this I want to be sensitive to the fact that many women have had a really tough time with pregnancy and delivery. Even just the decision for vaginal vs c-section is a tough one. But whatever you decide will be the best decision for you in the end. Our bodies are pretty amazing!

 

sincerely,

Lisa

 

I have a very healthy breast fed and still going strong 7.5 month old baby girl. I have had my jpouch for 5 years and didn't have any issues u till I got pregnant! Pouchitus along w multiple misdiagnosed bartholin gland cysts and still dealing with them. But as for baby she is wonderful and so strong n healthy. I worked with a high Rick pregnancy doctor that helped me soooo sooo much and we did a planned c section at 37 weeks three days. I had to get over the fact I may not be able to have children concidering what I went thru and got my jpouch. I got pregnant naturally which was so amazing! I guess after going they so much I just had gotten over the at home water birth part to I so badly wanted but could never get to do. C section was very strange being totally awake compared to the other surgeries but I tell ya it was nothin recovery for me! Nothin compared! I will have to say being pregnant did slow down my output but it came along with a whole new set of issues ; ( currently in an (abscess) fistula situation seeing doctor on Monday wish me luck 

 

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