I am three months post takedown surgery. Everything has been great, with the exception that I have tight Pelvic floor muscles I had to do pt and biofeedback for. I was having to strain a lot and then being in pain afterwards. But after the pt that resolved for the most part and I was doing well for a month.
Then earlier this week I started to notice slowly, I was having spams return when emptying my pouch, then the soreness started after, then I started having to really strain again to empty. After about 3-4 days of this I was in really bad pain during and for hours after a bowel movement. The pain being around the anus and sometimes all the way up to my tailbone, a deep aching pain and throbbing. None of my techniques or exercises I learned in pt were helping at all nor was heating pad, sitz baths, Tylenol etc.
It got so bad in the middle of the night I went to the er. They did a rectal exam and ruled out stricture and fissure. I had a ct scan that showed nothing but some enlarged lymph nodes and mild hazy fat stranding near the pouch, but no inflammation in the pouch itself.
I saw my surgeon and he said based on everything I’m saying and he’s seeing, he thinks it’s a muscular issue and sent me home with flexeril. It’s been about a day and half, and these have helped the pain and spasming by about 80%, so at least I can function.
However my concern is that it hasn’t helped the emptying issues. I’m going less than usual by about half and when I do go I still have to push and strain quite a bit, and don’t get nearly the volume of stool as before. Then I can feel the pouch isn’t all the way empty. I tried Metamucil and that made things worse. I stay plenty hydrated, and when I do go the stool is ideal constituency not too hard or too soft
I feel stuck and I don’t know what to do next. They practically threw me out of the hospital and left me with many unanswered questions, and my surgeon isn’t in today and then it’s the weekend.
Any thoughts on what might be happening or what I should do next? Is this just still early on stuff? I’m feeling just so down and discouraged
Edit to add I asked is this pouchitis due to the inflammation near the area, and they said highly unlikely because I don’t have increased urgency, bathroom trips, leakage, or any of the other typical symptoms of pouchitis and it wouldn’t come with that amount of pain, so they would not even let me try antibiotics. I asked about a scope and they said not needed.