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Hi All,

My surgeon removed my J-pouch after serving me for 14 years.(UC)
Now I'm with permanent illeo.

He left 10 cm from the pouch as stamped end and he did not close my a**hole. He was affraid to remove everthing at one stage.

Now I've a huge dischage from my butt, but recently after 8 months from my operation, I had a fistula between the reminder of my J-pouch and my abdominal wall.
Now I'm discharching sth like pus from my butt and from my abdominal wall.
I can't remove the reminder now becacuse of Job commitments...

My question is what should I take to help me reduse the pus and to heal the area; I can not take Pentasa,, you know why... it will get out from my abdomen:-((

How about Cepro 1x2 for one year until I remove the reminder.

Is there any risk to harm the nerves during the operation as the area is full of inflammation. Any hopes that the reminder of the J-pouch will become healthy as there is no stool passes there anymore.

Appreciate any ideas. jesus bless you all
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Long term antibiotics make sense. Sure, there are risksof side effects, but you can deal with that if they occur. Many people are on Cipro for years without problems. Bactrim (Septra) is also a possibility. Flagyl is a good choice, butthe risks of side effects are higher when used long term. If you've responded to mesalamine (Pentasa) in the past, you can take it topically, in the form of enemas or suppositories. Might help.

What do your doctors suggest?

Jan Smiler
I am currently taking Cipro for a fistula & two abscesses that formed because of it. My doctor says the Cipro should take care of the abscesses. Though I still have discharge, it is not quite as bad. When my stools are thicker the discharge is also less. Maybe some immodium will help too.

I have a follow-up next week to see where to go from here. I'm not really sure what the doctor will say about future treatment.
Don't know much about Ornidazole. Seems similar to Flagyl and has been used for treatment of Crohn's disease.

Might be wishful thinking on your surgeon's part that the fistula will heal on it's own. It does happen, but the odds are not high. Still, chronic antibiotic use should reduce the infection and the drainage. Waiting for surgery, even long term, will not alter your outcome. So, taking the "wait and see" approach is fine. Pouch removal is a big, big surgery, so you want to wait until it is as safe as possible and you are ready for the long recovery.

Jan Smiler
Pouch removal and anal closure surgery is a very complicated very big surgery. Supposedly it is far more complicated than colon removal or jpouch creation surgery. I would definitely only have an extremely experienced surgeon do this, one that has done it many times before. In addition, this surgery is at high risk for complications. So you want to be sure your surgeon and hospital is prepared to handle any potential complications. I can attest to this as I had my full pouch removal surgery done by the top surgeon at the best of the best facilities (Cleveland Clinic) and I still suffered with many extensive and significant complications. I couldn't imagine having had it done by anyone else or at any other facility that wouldn't have been prepared to handle it Also as you state.. you have to be prepared time wise for this. Nearly 3 months after the surgery, I am still out of commission.
I would think Canasa might help along with cipro.

It is possible to remove the pouch but not do the anal closure. This is likely what I am going to have done. According to my surgeon the general complications arise mostly from the anal closure, it is a difficult wound to heal for some people. Pouch removal to the connection point at the rectal cuff varies in complexity due primarily to the amount of adhesions. Since you have a fistula that would be another issue. I was told pouch removal and creating of an end ileo can take 4 hours and may not be possible to be done laprascopically or the pouch can just almost "fall out" and take a couple of hours or less.

Hi Liz11/ chiromancer, agree with you, no anal closure at any price,,, you can close it anytime later when you are sure that everyth went fine.

For me my surgeon, removed the fistula, made a perminent ellio (fuel tank for sex machine:-))),removed maby 70% of my Jpouch and left around 10 cm which were severely inflammated, and guess what, he close my a**. of course after 2 weeks he was forced to reoped it again:-((

I'm confused as some persons says that it shouldn't be resky as he planned to do the operation in two stages, the ellio firt then the reminder of the pouch.

Another important issue that I was the first one in my country who underwent the Jpuch operation and I'm afraid that I'll be the fitrst one who will remove it... not so many experienced Dr.

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