Just had a pouchscopy

You should probably ask your doctor that. 

Thanks Aaron; to be honest, without going into 'War & Peace'; My doctor's are a nightmare; they delegate appointments to junior doctors; it's a 3 month work in that department thing for junior doctors. I have pointed it out to a junior doctor previously. I just thought someone here May have experience of it.

Rebel, is this just your observation, based on the printed pictures, or is it something that the report (or the doctor) pointed out? The printing process may not be rendering color very accurately.

Gee, it all depends on the starting point (color). If it went from red to pale pink, that is a good thing, as redness equates with inflammation. However, if it went from pale pink to nearly white or grey, that means a poor blood supply and your pouch will not last.

If you have been feeling well and no one has told you there is a problem, I would not worry about it.

Jan

Scott F

Thanks for replying. It's from the pictures, but I also had a front row seat (if you know what I mean). They took biopsies (awaiting results), loads of ulcers, feeling bloated, tired and drained.

The full summary is as follows:

FINDINGS

Views to the pre-pouch ileum.

The pre-pouch ileum appeared normal.

The pouch inlet appeared ulcerated (three deep ulcers measuring > 1cm with erythematous intervening mucosa were identified).

There was one ulcer measuring about 12mm in the distal body of the pouch.

The rest of the mucosa of the body of the pouch appeared normal.

The blind loop of the pouch appeared normal.

Thanks in advance.

Jan Dollar

It's gone from 'red to pale pink'. I had the closure in early 2006. So I've had the J -Pouch for 12 years.

I do need to get the 'blood circulating'.

I've bought a hula hoop but it's still in it's box.

As well as the pouch I have Diabetes Type 2 and possibly MS.

So it's just a constant 'battle'. 

Thanks in advance.

Rebel, the ulcers are a significant finding. Given the report the paleness is unlikely to be meaningful, and may not even be real. I don’t think the hula hoop will do anything for your pouch. I hope there’s a plan to try to heal up those ulcers.

Scott F

The ulcers have been present in all of the last 3 pouchscopy's. The junior doctors have just said 'you don't need to worry about them' and dismissed them.

I've done some Googling - from an article, someone suffered pouchitis symptoms from one ulcer.

 https://www.ncbi.nlm.nih.gov/pubmed/3731967

Yeah, well those junior docs were wrong, I think. Ulcers, especially multiples with symptoms, mean pouchitis. Antibiotics are the main Rx. If they do not work, MS (if it winds up being apositive diagnosis) will be a contraindication to treatment with biologics.

Many docs would not need to wait for biopsy results to treat this pouchitis. The biopsies just help to rule out other issues. If it does turn out that you have poor blood supply (ischemia), there is not a whole lot you can do about it. Ischemia usually shows on a scope as a sharp line of demarcation between the affected area and the normal area. Could be pale, or inflammed. 

Overall, keeping your diabetes in check will help, as high blood sugars just promote inflammation.

Jan

Jan Dollar

Many Thanks. The Doctors got me on the Pouchitis thing; I'm under the impression that people with J pouches have a degree of Pouchitis all the time; they prescribe antibiotics after it reaches a specific level. I'll speak to the Pouch Nurses about antibiotics. 

To me everything you've said makes sense - 100%.