I need a good rant with people that get it... my family and friends are pretty darn sympathetic but it's something they just can't quite comprehend.

I went in for day surgery last week - exploratory under anaesthetic and the intention of doing a flap repair on recto-vaginal fistula. I knew going into it the flap repair doesn't have a great success rate, but the doctor figured since it's been 11 months since my colectomy/ileostomy that chances were prime having been redirected that long. Well - doc was quite preplexed to discover my rectum was a mess - diseased, inflamed, ulcered, a mess. So not only could he not do the repair, he's now in discussion with my GI to figure out what's next, probably removal of the rectum. So - now I'm trying to wrap my head around that... though I was still wondering about the j-pouch surgery, at least i thought it was still an option for me. So much for that....

bugger damn sh*t...

Hedster,

Don't freak out just yet. What you are describing with the rectum is not all that uncommon. I'm assuming that you have a "stump" left and this would generally be cut down during the surgery to perform the J pouch construction/attachment anyways. The same old UC type drugs should treat the inflammation and disease in the stump (Canasa, 5-ASA, Prednisone, etc) if you need to get it under control before surgery.

The issue of the fistula may be a little bit more complicated, but we have many members who are dealing with these in their J-pouchs and several have had successful treatment. In any case, you should make ure that you are getting multiple opinions and that your surgeon is experienced in both fistula repair and J pouch creation. If not, then you really need to see someone else.

I hope that things work out for you. My bet is that they will eventually but it may just take a little while until the rectal stump is treated and the fistula is repaired.

Rick

Have you explored the possibility of having a K-pouch? See Sharon!

Don't give up yet!
Good Luck
David

I think that most of us had serious inflammation in the rectum at the time of our j-pouch surgery, so that should not be any sort of contraindication. You may need to have the j-pouch surgery done at the same time as the flap repair, or maybe much later after the j-pouch is fully healed. Your OB/GYN surgeon needs to confer with your colorectal surgeon on this. Don't get your hopes dashed until you are actually told that the j-pouch is not possible.

However, something to consider is that if this fistula occurred before your colectomy, your risk of this being Crohn's is higher. But, if the fistula occurred after your surgery, then it could simply be a complication of the surgery and not Crohn's.

Jan