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  I've had my j-pouch for 15 years with never a problem so I had no idea what was going on except I knew I couldn't pass anything.   I came to the ER Monday night in such pain, I thought I was dying. I'm still in the hospital with abdominal pain around and across my belly button area. Not as severe, but still painful. CT Scan showed some kind of blockage - sounding like the area where I had the ostomy before reversal.  Finally, things passed. Probably because of the CT liquids they think may have pushed things thru. Stayed on liquids until last night. Started me back on some solids which is producing only liquidy diarrhea.  Finally going to do a stool study to see if there is an infection. May want to do another CT Scan (I hate the idea of all the radiation.). Also talk now of scoping the pouch - the only thing I remember Dr. Bauer ever saying was to let nobody touch that pouch. Wondering what some other experiences are with obstructions? Pouchitis? What you've had done?  How to advocate for safe testing. Scopes? The pain is bearsble now but I don't want to have this happen again if I leave not knowing what's going on and how to deal with it.  Any suggestions would be great.  

Thanks. Lisa Henserson

UC / J-pouch @ 15 years ago


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A scope might help find out what is going on inside. It could also, if it is an obstruction, be scar tissue choking the bowel from outside, especially if it is at a surgical site.


Make sure you have an experienced GI internist looking at your case ASAP, as well as a surgeon familiar with J-pouches. A scope in and of itself shouldn't damage anything, but the inferences drawn and treatment options are a different matter; it is important to have at least one person who knows what they are doing with pouches involved.




Dr. Bauer was understandably protective of his work. I can't tell if you're still seeing him, Lisa. You do need someone you can turn to if issues crop up. I prefer a gastroenterologist, but others choose to keep seeing their surgeon. As long as the person doing the pouchoscopy understands J-pouch anatomy and J-pouch issues, scopes can reveal a lot of information quite safely. Many doctors and patients advocate periodic scopes to monitor for dysplasia or cancer. This is particularly important for folks with FAP or if dysplasia was found before colectomy. 


For various reasons scoping isn't part of the usual bag of tricks in the ER, so I'd be surprised if someone there suggested doing it on the spot. It is the best way to see a pouch stricture, though.

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