Perforation in J-Pouch

EdwardK,

I have not had any perforations in 20 years with my J Pouch, but my recent pouchoscopy pics made me consider the possibility that it could happen as I have deep punched out ulcers in the pouch.

What were the symptoms that led you to know something was amiss such that you went in for emergency surgery?

The symptoms included a pain on my side and back, similar to a kidney stone which is what I thought I had. Throughout the day I became increasingly nauseaus and was not have as many BM's as I normally do. After a few hours I was unable to move due to the pain and called EMS. I had an MRI and a few minutes after the results were read I was told that I needed emergency surgery. It all happened so quickly that I am still having trouble processing this. Everytime I get a pain or unusual feeling I convince myself that this is another perforation. I was told that this is extremely rare.

Edward,

Do you have any history of pouchitis or inflammation of the pouch? It seems odd that you would have a healthy pouch and then suddenly after 8 years it would perforate. Did they give you any information as to how this was caused? Do you play any extreme kinds of sports like rugby or hockey where you could have torqued the pouch in such a way to have produced such an injury?

I do not have a history of pouchitis or inflammation. My output has always been frequent and not very bulked. I had a capsule endoscopy a few years ago and all was fine. I do not play contact sports but I am an endurance runner and regularly train for marathons and half-marathons. I get a physical every year and with the exception of a j-pouch I am in great shape.
My colorectal surgeon who fixed the perforation consulted with other surgeons in her practice,they had not seen this before in a pouch. My GI said that I could have just moved the wrong way. Needless to say, the uncertainty of why/how this happened has caused a significant amount of anxiety. In fact, I was in Tampa on business this week and went to the emergency room because I was feeling similar symptoms (I actually had to get off a plane after the door was closed). The CT scan showed a full pouch that could have been causing discomfort and pain, luckily no perforation or leakage.