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So I apologize in advance if this is too much information but don’t know where else to go/ask. I’m a young gay male with a j pouch and have anxiety that I’m not going to be in a healthy relationship if I’m not able to bottom once and a while. I can fit a couple fingers but is pretty tight around the suture sight about 3 inches in. Would I be able to stretch it slowly or just give up? 

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Hey Austin...its really not advisable. How old is your pouch? BUT...see how it goes. Our bodies are all different, and you have no idea of how your body will adjust. Hopefully someone is Private messaging you ...

Head's up...ALL of use who are single or were single at time of surgery...all worry about having a healthy relationship...ALL of US...(if we are interested in relationships) ...All of this take some time. 

@Former Member posted:

No J poucher should empty their pouch without attempting to resist the sensation; so to stretch the pouch and become accustomed to the various urges, feelings and sensations; thus learn how to control the pouch, to reduce daily BMs; rather than allow the pouch to control the life of the J poucher.

Strange is 100% correct about this.  I had the best colorectal surgeon in the USA at the time of my surgery in 1992 (the late Dr. Irwin Gelernt of Mount Sinai Medical Center in NYC) and this was emphasized to me over and over and over again.  I followed the advice. I was also told it stretches the pouch.

Last edited by CTBarrister

Just in case there’s any confusion: “stretching the pouch” has nothing to do with dilating the anal canal and anastomosis. Self-dilation is appropriate for strictures, under the guidance of a professional. I suggest taking the time to find a sympathetic gastroenterologist or (even better) a colo-rectal surgeon for guidance here. It may take a few referrals to find the right one. Over-dilating can lead to incontinence, and that’s much worse than a sex life with some compromises, I think.

Hi Austin, I just want to caution you not to try to dilate without a professional, like a surgeon. You could do serious damage to your sphincter muscle. I'm one of those people that has to self dilate because of a stricture. My surgeon did the first dilation, and I do it periodically to keep the opening. He did this with Hegar dilators. I think you need to go back to your GI or surgeon and see what they think is possible. I understand it has to be hell for you, and I'm  not saying it's not possible, I'm just saying do it right. Remember that we've all walked through hell before our pouches. Good luck, I hope you find a doctor that can help you.  

Aimee

*AUSTINA711* Do not risk having anal sex no matter what people say, the right surgeons and doctors would never recommend that. I know a lot of people on here can be very rude/negative and try to compare stories but its strongly recommended that J-pouchers should not attempt that. A lot of people on here shut down what I say or even say what I am doing is wrong without even asking about it or looking up the risks, and that is their choice. 

Also Austin: Holding in poop can lead to overgrowth of bacteria and can lead to permanent constipation along with other things, but if people want to risk that or choose not to look it up, that is there choice as well. 

Lastly Austin, Ask yourself this, "Is anal receptive sex worth the risk"? Its your choice of course, but considering everything we have been through its definitely not worth the risk. A surgeon once told a guy that if he participates in that it could also cause damage to the other partner because the staples in the pouch can injure your partner's penis. It could hurt you and him. There are a lot of other risks besides that too. Everything is your choice and I hope you choose wisely.

If someone truly loves you, it will not matter. Find someone that loves you for you. 

Last edited by Lauren Of Emerald City

Staples? Can someone elaborate on the staples? I thought they were not permanent. 

My surgeon, or his PAs, never told me to hold and stretch the pouch. He is Dr Remzi, if that makes a difference.  I had my takedown just before the pandemic, so I have been lucky to be always close to my bidet since then. I never "practice" holding. I tell myself, once the world gets back to normal, there will be many opportunities to hold and stretch the pouch, when my bidet will not be just around the corner. I now enjoy IBD free life with no unpleasant feelings down there, while it lasts... Don't we have many years to stretch the pouch anyways? Would it not eventually stretch? Maybe they recommend the holding practice to patients with professions that require it stretched ASAP, for example a Fedex driver who cannot find a restroom for many hours, and has to go back to work 6 weeks after takedown? Why the hurry, otherwise?

I really do not mind the frequency during the pandemic. Once and if frequency proves to be a source of frustration, then I can practice holding and stretching, but unless that happens, I do not think it is essential. Comparing this to anal sex ignores the risks involved. What is the risk of not stretching a pouch vs the risk of anal sex with a pouch?

I have to emphasize that I am not writing to tell AustinA711 "NOOOO, DON'T DO IT!". He obviously already knows the risks, and aware of the fact that it is not recommended. 

I wrote this post to mainly defend the "not-holding-it! rebels" of this community. Yet, while I am here, I want to say AustinA711 one thing: It makes a big difference if you yourself miss being bottom a lot and willing to take the risk, versus you want to take the risk just to make your partner happy. You say that you want to have a health relationship. If you do things that you do not want to do, only to make your partner happy, that does not sound very healthy to me. If I were your partner, I would not do it to you, even if it were a casual relationship.

Last edited by Elif
@Former Member posted:

Withholding output to stretch the J pouch has no connection whatsoever with receptive anal sex.

It’s recommended by J pouch Surgeons, to help reduce urgency and the number of daily BMs.

I would agree with this. It seems like a topic for a separate thread.  But yes, it was recommended to me and in conjunction with that recommendation I was also told to do kegel exercises to strengthen the anal sphincter muscles.

Last edited by CTBarrister
@Elif posted:

Staples? Can someone elaborate on the staples? I thought they were not permanent. 

As far as I know, this is correct.  I was told that mine were designed to and did "dissolve" after surgery.  That was in 1992 and I do not know what that actually meant. There is no "hardware" left in my J Pouch, if there were, it would be visualized on abdominal ultrasounds and other tests and commented on by the radiologists.  This has never happened in my case despite many such tests.  

Furthermore if metal was left in your body you would be tripping airport scanners and metal detectors in our Courts, and your surgeon would have some obligation to inform you of these possibilities.  It would be a comedy show if you tripped an airport scanner due to embedded metal and could not explain to a TSA agent what you are carrying inside your body- one that I would not want to act in.

I got this from Colitis Ninja which describes the "modern" procedure and indicates the staples are actually removed transanally and do not "dissolve", so this could represent a difference from what I had done (or from what I was told I had done):

http://colitisninja.com/2016/08/j-pouch-construction/

Last edited by CTBarrister
@Elif posted:

Staples? Can someone elaborate on the staples? I thought they were not permanent. 

My surgeon, or his PAs, never told me to hold and stretch the pouch. He is Dr Remzi, if that makes a difference.  I had my takedown just before the pandemic, so I have been lucky to be always close to my bidet since then. I never "practice" holding. I tell myself, once the world gets back to normal, there will be many opportunities to hold and stretch the pouch, when my bidet will not be just around the corner. I now enjoy IBD free life with no unpleasant feelings down there, while it lasts... Don't we have many years to stretch the pouch anyways? Would it not eventually stretch? Maybe they recommend the holding practice to patients with professions that require it stretched ASAP, for example a Fedex driver who cannot find a restroom for many hours, and has to go back to work 6 weeks after takedown? Why the hurry, otherwise?

I really do not mind the frequency during the pandemic. Once and if frequency proves to be a source of frustration, then I can practice holding and stretching, but unless that happens, I do not think it is essential. Comparing this to anal sex ignores the risks involved. What is the risk of not stretching a pouch vs the risk of anal sex with a pouch?

I have to emphasize that I am not writing to tell AustinA711 "NOOOO, DON'T DO IT!". He obviously already knows the risks, and aware of the fact that it is not recommended. 

I wrote this post to mainly defend the "not-holding-it! rebels" of this community. Yet, while I am here, I want to say AustinA711 one thing: It makes a big difference if you yourself miss being bottom a lot and willing to take the risk, versus you want to take the risk just to make your partner happy. You say that you want to have a health relationship. If you do things that you do not want to do, only to make your partner happy, that does not sound very healthy to me. If I were your partner, I would not do it to you, even if it were a casual relationship.

Thanks for defending me People do not ever defend me so its cool to meet someone that did I am almost 6 years in with my pouchy and I go about 13-20 times a day, and I am doing just fine, so will you <3

I got a scan and it showed a bunch of staples. I don't know what the staples are made of, but I have never set off a metal detector. 

Lauren - you definitely have supporters who are also offended by the bullying on here. I don't practice pouch stretching, nor was I told to by my top surgeon, and I have no problems with urgency or anything. 

OP - I think asking your doctor would give you the best information about your question.

@Kangaroo posted:

I got a scan and it showed a bunch of staples. I don't know what the staples are made of, but I have never set off a metal detector. 

Lauren - you definitely have supporters who are also offended by the bullying on here. I don't practice pouch stretching, nor was I told to by my top surgeon, and I have no problems with urgency or anything. 

OP - I think asking your doctor would give you the best information about your question.

Thank-you Kangaroo I appreciate that very much! I cannot believe how some people can be on here, but it seems bullying is everywhere. I just like to ignore it and not let it defeat me, thank-you again for defending me Kangaroo

Last edited by Lauren Of Emerald City

Spouse of a patient here...just my two cents, for what its worth...

Staples:

I asked my husbands surgeon about staples because we travel fairly frequently (at least we did pre-COVID) and I was concerned he'd set off the scanners. She advised that there weren't any internally. The only staples used were on his incision which occurred because there was too much scar tissue to work laparoscopic. I wonder if the connection type (pouch to anus) used depends on the surgeon?

Holding:

He was told to practice "holding" to stretch the pouch over time. This was advised by the surgeon, her assistant, and several support group patients. I wonder if its a locality thing and what information has reached where. We're in So Cal.

Talking with your surgeon and gastroenterologist should produce better and more accurate answers.

Now for my two cents not just as a spouse but also as a patient advocate...my opinion is ask, ask, ask. This is the motto I stand by regardless of the health issue. Don't be afraid you're making the doctor uncomfortable discussing. It's their job to guide their patients and you are paying them to guide you in your health which includes life after surgery.

Lots of love, T

Re: Internal staples, an FYI

Please note that we may or may not have retained internal staples. It all depends on your surgeon’s technique. My j-pouch happens to be hand sewn, not stapled, but stapling is fairly common. Staples  do NOT set off metal detectors at screening areas. The same is true for the fillings in your teeth. Vascular clips are also commonly placed in abdominal surgery. I know I have some of those clips and have never set off a metal detector.

If you do have a stapled pouch you may have shed many or all of them during the healing process. Some people see them in the toilet bowl, some do not.

Jan

Last edited by Jan Dollar

I know this is an old thread so I apologize for reviving it.  My fiancé wants to try anal sex and I made an appointment with my doctor to get educated on the subject. I have a Jpouch (done in 2003) and my doctor told me that it’s safe as long as it’s slow, there’s lots, LOTS of lube and it’s not frequent (maybe once a month). We haven’t tried it yet cause even tho I was given the green light I’m apprehensive about it since I don’t want anything to damage my pouch. He didn’t look at the type of Jpouch I have or anything but then again he’s been my doctor since 2002.

With all that said we have done fingers, and each time it was less painful than the last, I can take 2 right now and they don’t go all the way in (again I get scared of damage)



Now I’m worried after reading some comments and other posts about this tho 😬

@Ellie

See the last page here:

https://cpb-us-w2.wpmucdn.com/...ke-Down-Recovery.pdf

What kind of a doctor do you have? Is this a GI or a surgeon? Anal sex is usually not recommended, and in this document it says “prohibited”.

Your fiancé does not sound like a person who would stick around if you were to go back to an ileostomy. No possibility of anal sex with a Barbie Butt. This sounds like a great test for finding a good husband. If he dumps you because you don’t want to have anal sex with him -with a j-pouch!!- then it is great news! You won’t spend your years or even decades with a person that is not right for you. Many people with colons are not interested in anal sex, and the same husband-fitness-test also applies to them. But in your case, it is a test that you cannot waive. Your future husband has to pass that test, and your fiancé fails it. If I were you, I would dump him even for wanting to try it.

@Elif

Who hurt you? Those are bold assumptions lol. My fiancé definitely wouldn’t leave me if I ended up with a ileostomy, we talked extensively about the risks and pros vs cons. We just like experimenting and this is something he wanted to try, he’s not forcing me or pushing me to it. I willingly want to do it, since it’s something I enjoyed before my surgery. He passes every test because our relationship is more than just sex, and he’s been there through thick and thin. Don’t project your insecurities or relationship trauma onto others.

and just to answer your question he’s a GI. Would ask my surgeon but he passed of old age about 5 years ago

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