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Hello all,

I needed some advice from the friendly forum as over the past week or so I have been really really struggling with my pouch! I have had my j pouch active for around 20 months and all has been very well in those months (minus a few minor setbacks!)

It started off with getting symptoms of frequency and cramping around the middle of my abdomen, then increased frequency at nighttime, extreme night sweats, fever, fatigue and nausea. My output from j pouch has turned to complete diarrhoea which is almost always green (sorry for the TMI). I have had bloods done which show slightly elavated CRP levels which apparently could mean I have some sort of an infection? Yesterday and today my stool seems to have bulked up quite a bit but I’m struggling to pass anything as I feel a stabbing pain in my rectum accompanied with pretty strong stomach cramping right before I need to go.

I am keeping up my water intake and resting as much as I can but I need some advice on this as I am really struggling and the low grade fever doesn’t seem to be passing. It seems to be particularly worse in evenings when my fever gets worse, I get shivers and generally feel quite awful.

I welcome any and all advice. Thanks in advance.

Last edited by VB_93
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Hi Scott,

Thanks for your reply. So I’ve got a bottle for a stool sample which I’ll be handing into the hospital on Monday. We had been away on a family weekend away 2 weekends ago but I don’t think I consumed anything I deemed as bad for me. I would say it’s probably worth noting that I was on a course of omeperazole for my acid reflux which I stopped last week too - I don’t know if this would have an affect on anything?

It could certainly be pouchitis, as severe cases can mimic all sorts of things. I could have sworn I had an inflamed gallbladder based on my symptoms, but nope, pouchitis it was! But your chills and fever have me concerned, so be sure to stay on top of it and keep your doc informed. If the fever goes high or the chills become violent (like teeth chattering shakes) you need to go to the ER to rule out sepsis. You are doing the right thing by staying hydrated and resting.

Jan

Thanks for all the replies, it’s been very useful. So I had no night sweats last night (which is a miracle given the hot weather we’ve been having in the UK at the moment). My rectal area still feels quite sore and I have a throbbing, kind of stabbing type of pain just before I need to go for a bowel movement. What’s going on here, I do not know! Stomach seems to ache in the nighttime still and my output is a mixture of runny and formed with lots of yellow-ish/green fluid. I’m trying to keep hydrated by drinking oral rehydration solutions.

A question I did have is would probiotics help me out at all? I have heard good things about VSL#3 through my stoma & pouch nurse. I really don’t want this to be pouchitis and have a round of antibiotics.

Last edited by VB_93

Update: Managed to pass fairly decent amount of formed stool since yesterday evening. Fever symptoms etc. seem to be fading. The only thing now that is getting to me is the sudden and sharp onset of a stabbing rectal pain that I get when my pouch is even slightly full. The pain lasts for seconds and then passes as quickly as it comes. I usually have a bowel motion and things will calm down again for a number of hours. I have been looking into something called “proctalgia fugax” and it seems very similar to this. What is this usually caused by and how can I sort it out? Sitz baths, anusol?

Regards

@VB_93 posted:

Update: Managed to pass fairly decent amount of formed stool since yesterday evening. Fever symptoms etc. seem to be fading. The only thing now that is getting to me is the sudden and sharp onset of a stabbing rectal pain that I get when my pouch is even slightly full. The pain lasts for seconds and then passes as quickly as it comes. I usually have a bowel motion and things will calm down again for a number of hours. I have been looking into something called “proctalgia fugax” and it seems very similar to this. What is this usually caused by and how can I sort it out? Sitz baths, anusol?

Regards

Are you drinking a lot of water?

Thanks Lauren,

So today the fever, the chills, stomach ache etc all seem to be a lot better. Only thing that’s still bugging me is the sudden and quite sharp stabbing pain that ensues every time I feel like I have stool/gas in my pouch. The pain is a short throb (almost like a cramp) and then disappears as quickly as it arrives. This will happen every 5 or so minutes until I’ve been to the toilet. Never had this before and it’s not normal for me. Any suggestions?

So I’m beginning to think what I have is indeed pouchitis. The only contrary things that lead me to think otherwise is that my stools have formed up and I’m not seeing any blood. However, the tailbone pain, urgency and nighttime frequency are all pointing to pouchitis. Please let me know what your thoughts are on this.

Call your GI. At least in the US they will often prescribe a course of metronidazole or ciprofloxin based on described symptoms alone. No need for an urgent appointment and poking around in painful places (yet). Another thing to think about is the possibility of an anal fissure, as your new rectal pain sounds a lot like one. It is often associated with straining at liquid or formed stool. Hermorrhoid cream can help while you get this sorted. And, no, probiotics will not treat what you have right now.

Jan

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