Hello all. I saw a similar post down below, but my situation is a little different, so I decided to start a fresh discussion. I am 19 wks pregnant right now and have had terrible diarrhea for about 3.5 wks. I was basically unable to eat solid food for most of that time, surviving mainly on Boost, soup and milkshakes (not great when you are pregnant, I know). I have been taking Pentasa for years, but haven't had a bout of pouchitis for well over 5 yrs now (my J-pouch surgery was in August 2001). I saw my gastro doc 2 wks ago and he basically doesn't want to do anything, since I am pregnant. He did put me on a double dose of probiotics and I've taken them for 2wks now. The diarrhea has slowed down quite a bit, but still more than I would like. However, I still just don't feel well. I have no energy and a constant low level of abdominal pain. I just saw my gastro doc again and he said that there is nothing he can do and I will likely live with it for the rest of the pregnancy (I'm due in June). In addition to the things I already mentioned I have had problems with a tiny anal fistula getting inflamed and being terribly painful and now I'm beginning to form a fissure. It seems like nothing is going well for me. I guess I'm just looking for some reassurance that things may improve or suggestions of things I can do. I really need to get back to work and that's practically impossible with my current condition. Thank you for listening to me!

Try increasing your fiber, maybe with daily metamucil or something?

Different people's pouches/guts react differently to pregnancy. My sister has IBS and had diarrhea pretty much the whole 9 months (yes, she was miserable but yes, you do get through it). She took a lot of baths, which helped with discomfort. My pouch went the opposite way when I was PG, I had more formed stools than I had ever had since the surgery, and no diarrhea. so it just depends on the person.

I am pregnant too (25 weeks). I had my takedown surgery June 2009. I have had very bad pouchitis since I got pregnant and have had to take pentasa 3-4 times a day, which didn't really help. My only relief was to take a half a hydrocodone which the Dr. said was ok, but I was concerned for the baby. My Dr. did an allergy test on me and it turns out I am allergic to gluten. Sometimes pregnancy can cause your body to be allergic to things it otherwise wouldn't be. Since I have cut out gluten I feel better. Still some pain but not as bad. Try cutting gluten out of your diet and see if you feel any better. (Gluten is found in flour, wheat, etc).They sell gluten-free products at health food stores and some grocerie stores.

So I went to an OB appointment after I saw my gastro doc and she was angry that he told me I would just have to live with my current situation. She called him and asked him why he wasn't treating me with something like prednisone or Remicade. He said that he has to have confirmation that I really have pouchitis, so I am scheduled for a colonoscopy (do they still call it that when you no longer have a colon?) on Friday. My OB is high risk and she says that she has several other patients on Remicade for other problems, so she recommended we try that after the test results. I was just happy that someone wants to take action! I'm not so sure how I feel about taking a lot of medication during the pregnancy, plus I had a bad reaction to Remicade in the past. I will just see what happens one day at a time. Thanks for your comments, I never really considered a possible allergy. I will try and experiment.

You can take entocorp which will help with some of the abdominal pain and inflamation. Immodium is ok or a low does of levsin. Canasa is fine too. Baths, BRAT diet for diahrea, topical numbing med like nupercainal helps a lot with the fissures.

Just so you know, I have a very similar situation. No guarantee that it is pouchitis, but it probably is. I have several anal fissures which are terribly painful, plenty of bleeding and abdominal pain and finally decided to treat it. My pouch specialist told me the first line of defense against pouchitis during pregnancy is amoxicillin. Since I am usually required to take only Cipro, I was worried that this would be hard on my stomach as it has been in the past, but he said if I have a problem I could use cortifoam. I began the amoxicillin a couple of days ago, and my pain level and bleeding are reducing, however the fissures remain to be a problem. I am supposed to continue this treatment for 7 days. He also suggested remicade if this does not work, but he is a very cautious and knowledgable person and feels this should work and is safe for baby. So, you might want to mention it to your doctor. I also asked how he could be sure it was pouchitis w/out examining me, and he said the amoxcillin would help a variety of issues and if it did not get better with that, then he would see. But both him and my OBGYN said it is PERFECTLY safe during pregnancy. Good luck with the rest of your pregnancy. I kinda feel like this pregnancy has been a major pain in my a** so far, but I wouldn't trade it for the world

I'm there too...I had constant diarrhea...I had to go every hour or two hours at the most. Mine has finally slowed down because I've been taking Augmenten (spelling?) due to a bacterial infection, as well as iron because my iron was low. Those two drugs combined have thickened up and slowed down my bowels. I still have leakage issues but I assume that is just because the baby is pushing on everything...

BTW, are you taking prenatal vitamins? Most of them have stool softners in them so you need to make sure you get one that doesn't have that in it. I had to go to a natural drug store to find a special prenatal.

Hope you get some relief soon; it can get pretty miserable!

So I guess I will just give an update to my situation. My gastro doc ended up scoping me and found a ton of inflammation in the pouch. He is concerned that I actually have Crohn's, but has no proof (no granulomas showed up in the biopsies and I've never tested positive for that blood test). Anyways, he and my OB discussed it and chose to put me on prednisone to get this cleared up. I have been on 40mg a day for 2 wks now and will start to taper tomorrow morning. I am feeling much better. Unfortunately, the prednisone is messing with my blood sugar levels and so now I am on a diabetic diet and having to monitor my sugar levels all the time (Boo!). My gastro doc says that by the time I get down to 10mg prednisone it should stop being such a problem. I never realized how many carbs I ate previously! But the baby is doing well and that is really all that matters in the end. In the past I've had problems tapering off of prednisone and I really hope that won't be an issue this time, especially since it's such a short treatment. Thanks again for all of your suggestions and comments.

I was wondering if you were awake during your scope or if you got the twilight drugs so you didn't remember the procedure? I have had over 50 scopes in the past 2 years because of complications with a perforation in my pouch and that caused a stricture that I had to have dilated every 2 weeks for 14 months. I was starting to feel a little normal after all this and then i got sick. i was tired and just feeling yucky and my stools were more frequent and runnier. I found out I had pouchitis but the first Pathologist said the biopsies were positive for IBD which would have meant Chron's! YIKES! My awesome GI doctor sent the biopsies away to a Pathology specialist that re-tested them and they concluded that I was positive for inflamation consistent with pouchitis not Chron's! Thank goodness. Anyways, my point is that we have been unsuccessfully trying to get pregnant for 9 months now and my GI doctor keeps telling me if I have any problems when I get pregnant no GI doctor will want to scope me or dilate me if I am pregnant. I will have to do IVF in order to get pregnant because my fallopian tubes are really mangled and wrapped behind my uterus and my ovaries are actually touching. It's really crazy and frustratins. I was just wondering if you were awake or asleep during your scope?

When I was pregnant, I had pouchitis. My surgeon confirmed it by a simple scope that took all of 45 seconds to look inside the pouch. I was awake and survived it just fine. I was put on Flagyl, which is safe in the second and third trimesters. My OB said no to Cipro.

My baby girl is healthy as can be!

Baby blessings!!