Hi all,

Trying to stay positive as am my wits end here and could do with some experience and wisdom from the community.

Cannot empty my pouch properly at all since last Saturday ( 5 days). Had my last stricture dilation exactly two months ago. Function has been relatively good since then, with diet more varied.

All of a sudden can't empty and have done the following

Gone on a liquid diet for last 4 days, started a course of cypro ( no change noticed yet), avoiding all gas producing foods, lying on side to regain some measure of pain control and relief to evacuate. I really don't understand why I can evacuate lying on my side and not on the loo! Any knowledge on this?

So wandering how long this will continue for, whether I should see someone about it ASAP. Thought I'd come on here first and ask everyones opinion and suggestions.

Have had the following thoughts:

Get some anti spasmodic/ anti inflammatory to help open/ relax the anastomosis
Learn to self dilate on-going if stricture related
Re-dilate surgically
Continue with antibiotic course as probably an attack of pouchitis
Drink more fluids ( although this actually makes the pressure worse)
Any other suggestions?

Thanks in advance for any ideas or support. Sometimes I really feel this is the best place to go as doctors and specialist seem disconnected to the urgency/ disruption this is causing. It's very easy to get disillusioned with them!

Best

Mike

The cipro really slows things downs and makes things very thick. Why are you on the Cipro? Can you get off it? That may help. A water enema may help to clean the pouch, but only do so with your doctor.

Colace should be safe to take.

make sure u take a probiotic, also 2 Rowasa enimas (1 in morning and 1 at night) should help. Baby food,table spoon of rice bran should help.

It could be anything. Could just be a fluke. But, If it were me, I'd call my doc. You may need to be sure you don't have a partial blockage or a stricture higher up. When I can't poop, that's a big signal to me that something is up. I can't empty my pouch well either, but I didn't actually notice it. I had a defecating xray study where they x-rayed my pouch while I pooped barium and only about 1/3 of the barium came out. My anus didn't open properly to allow stool to pass and anytime I would "strain" my anus would basically just close up. I'm going to physical therapy to try to fix this. She did mention that it might be helpful to get a stool or something to prop your feet up on when you poop as western toilets are a completely unnatural pooping posture. I did have strictures at the anastamosis sight that eventually required surgical dilation, but I'm not sure if that had/has anything to do with my current "anal" problem. You need to stay on top of this as improper emptying can cause pouchitis.

When I forget my VSL 3, I can't go. I get the strong urge, but once I'm on the toilet, no go. It's maddening. Keeping up on the probiotics is what usually helps me. Other times it's because I havent had enough liquids that day.

to me, the fact that you can evacuate on your side and not sitting up lends itself to some type of structural problem like a folding or twisted pouch or some sort of pelvic floor problem, but it could also be many other things, most of which have already been mentioned. If you're evacuating, regardless of the position you have to get into, and or passing gas it's probably not an obstruction. 5 days of cipro should be enough to at least show a difference (at the 500mg twice a day standard dose) if it was pouchitis, unless you've taken it for so long that it's ineffective (have you?).

Point being, as many have said, get this checked out immediately. Not being able to evacuate is a serious problem. Are you vomiting? Do you tolerate the liquids? Any bleeding?

Well hopefully by now you are feeling better.
Let us know.

I have problems emptying my pouch and I SO GET IT when you say you can empty lying on the floor.
I have to lie on the floor to fart. And then sit on the loo to empty.
I have to do this process up to 10 times until I have emptied.
But I also have to take epsom salts before hand, 2 tsp dissolved in a glass of water.
Without the epsom salts, nothing moves.

I recently consuted another surgeon due to constant pouchitis and problems with elimination. He suggested that I insert a rectal catheter and flush pouch out, three times a day with a syringe filled with water.
This has aided elimination and assisted with the severe rectal burning and pouchitis that I have experienced since January 2007. For the last two months I have been flushing out my pouch and feel that the inflammation has decreased. The situation is not perfect but I am coping better. Hopefully in time, this will improve more. Take care.

I am having this problem from time to time. I get sore inside if I don't go as often and I spend a lot long in bathroom if I don't go often. I use to go every two hrs. pretty much no matter what I ate. Don't know if its the same as people with a colon that are older and have problems going. Sometimes I can't even get out gas. If I press on the upper right hand corner it will usually come out. Had same test you talked about that said I have problems emptying in the middle and at the end but Dr. did it to see how bad pouch was prolapsed but other than that acts as though its not significant. How can that be? Blows my mind! Not like I am saying I'm having a problem that a test does not back up. Frustrated and ready to give up. If I go the other way my outer side of butt gets in a mess if can't go good pain in the upper right hand corner. Haven't been able to get it right on my on and no help from doctors.

Sorry forgot to say I know someone that uses water to empty often during the day and says if he doesn't he gets really sore for several days. He does it because he says the acid bothers him. I haven't tried but if I did it would be for a different reason.

For acid, Questran binds the acid and prevents burning. It also thickens things a bit. It's an old product that saves me when I start having soreness issues.

I tell you. It gets very frustrating! My last surgeon said someone without a colon does not need to take questran. I use to take it but then I was having the other problem. Now I am having problems emptying as I posted before so I don't need anything to help thicken. Sometimes I wonder if any of these doctors have the answers. I do think different things work for different people. I had one surgeon spray my bottom for butt burn and they have patients that come in about a week later and its still there and it helped them so much. Mine was gone before the next morning. Sure wish it had worked for me and I don't know why it didn't and they certainly didn't understand. If it worked I was all for it.

I was reading this article in Discover magazine about this doctor who was so excited to finish school and go out and heal people. Once he graduated, he quickly realized that about 50% of the time he had no idea what was wrong with people, he treated the symptoms and hoped things would get better and often they did. This is something I try to remember when dealing with docs, they aren't invincible and there is so much they don't know.

I agree KK, I have doubts that some Drs fully understand my problems, and how to deal with them.

Read some of my recent posts MikeJC in regards to how I deal with a pouch that won't empty.

Difficulty emptying