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That sounds like an insufficient prep and also could be why you're irritated.  I have been told CLEAR liquids after Noon the day before, and either fleet or tap water enema 2-3 hours beforehand.  I would be surprised if they got clear pics.  I have been doing pouchoscopies 22 years with 3 GIs and my instructions haven't wavered.  I also sat in a recovery room one year pre-procedure waiting for my Doc to arrive and you would be surprised at the number of people who have poor scope results due to insufficient, sloppy or lazy preps, resulting in inflammation and polyps being hidden from view.  I have heard Docs commenting on it through the curtains.

 

Pouchoscopies are one and done, it's not like baseball where if you hit a foul ball you get another swing.  You have a bad prep, there is no do-over (or if there is, your insurance company will not be paying any part of it).

Last edited by CTBarrister

Insufficient preps are very common with colonoscopies, but a pouchoscopy is a much smaller procedure, and the pouch is easy to rinse out with an enemaa or two. I think a laxative is probably more than is necessary (and more than most of us do), though reducing food intake the day/evening before the procedure can keep the view clearer during the procedure, and probably make it easier to examine into the small bowel (the "neoterminal ileum"). I don't think a light prep is responsible for post-procedure irritation, and most folks bounce back quite quickly from a scope with no sedation. If things were already irritated (e.g. with significant pouchitis), or a stricture was fiddled with, or a high number of biopsies were taken the recovery might be delayed.

 

That being said, although my pouch is generally very well behaved (thank you Cipro and Flagyl!), on some days (perhaps 5% or so) I just produce liquid stool, with or without a cause I can attribute it to. As long as I don't have urgency and it doesn't persist I don't pay much attention.

The surgeon said the pouch looked good in all aspects, not inflamed and no polyps. He seemed to be able to rinse as he went to get a clear view and there was not a whole lot of stool. I'm still uncertain about what is causing the watery stool.  I was hoping the response would just confirm that it's normal. I guess I'll wait and see if it passes. I think sometimes I get worried too quickly.

I think it is not unusual.  In 48 hours you should be back to your normal self.  In the past I was irritated after my pouchoscopies and my GI told me it was the prep (Fleet enema) so we cut back from 2 enemas to 1 and then I went to a warm tap water enema and had no irritation.

 

In your case it could also be irritation from the actual procedure, the inflating and swabbing of the pouch, etc.

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