Skip to main content

So my wife is 10 months post-takedown.  Been an incredibly long road to say the least.

 

She had a new issue last week that thankfully is much better today but I am interested in some of your thoughts.

 

So she was in a 4 month long daily regimen of 4-6 lomotil plus a morphine ER twice per day.

With this regimen she was having 6-8 bms per day, which has been absolutely fantastic.  All of a sudden she went 24 hours with 1 bm and increased abdominal pain, plus malaise and general flu-like symptoms.  Pain was not associated with eating but everything obviously slowed down tremendously.  Went to GI the next day and while still in a lot of abdominal pain, she was not bloated, so obstruction was ruled out.  GI suspected incomplete emptying and advised to use a enema 1-2 times per day.   After enema did not help a Flagyl was started and within 12 hours, pain resolved and bms normalized.  Malaise seemed to take 3-4  days to improve significantly.  So easy Pouchitis diagnosis??  

 

Just in case you are interested in other possible contributing factors.......

 

Daily Cipro for last 6 months....

30mg Hydrocortisone (suspected Pituitary insufficiency after 5 years of roids) 

Methotrexate (suspected inflammatory athritis..., could be due to Pituitary...)

 

Great news is that she's feeling great today and because of acute illness, immediately stopped all Lomotil and has weaned off of all narcotics (in one week)....Yay!

 

Will see what happens when we try to discontinue Flagyl then Cipro....

 

Thanks for the thoughts..


Dan

Original Post

At first glance, I'd say no, this does not sound like pouchitis. Diarrhea is a hallmark symptom of pouchitis. But, your wife has a lot going on. Overlapping problems, lots of meds, and a difficult recovery/pouch adaptation. I had some pretty bad pouchitis without severe frequency, but a LOT of abdominal pain.

 

Six months of Cipro is a long time, so switching to flagyl makes sense, since bacterial overgrowth could still occur on Cipro.

 

Now that she is off bowel slowers and opiates (good for her!) she can gradually add a little back. Maybe not expect the same low frequency, but shoot for tolerable instead.

 

Jan

Add Reply

Post
Copyright © 2019 The J-Pouch Group. All rights reserved.
×
×
×
×
Link copied to your clipboard.
×