Dear Jan Dollar;

i just found out i have a fistula.
The dr report states this-there is a retrograde filling of the j-pouch and distal ileal loop to the level of the colostomy bag.Asmall fistulous connection is seen posteriorly which appears to demonstrate retro grade filling of the more proximal segment of small bowel..


Jan could you explain this to me in laymans terms,and if i should see the dr soon about this.

I have a schedualed surgery at cleveland clinic may 17,for what was going to be a takedown and reconstruction of my j-pouch,however i just had an additional test of my spincter/contienence and the results were not good.Agording to the dr my spincter and rectum area was damaged during surgery and the prolonged aftermath .he thinks i should go to perm bag as i now only have about 25% of my control left.

Iwould appreciate any info or advice you can give me,as i value your input.sincerly gary.

god bless you.

Sounds like you have a fistula from your pouch to another area of small bowel. This is a fairly typical presentation of a Crohn's fistula. It may or may not be problematic, but if it is large, you can lose a lot of nutrients that bypass the small bowel before getting to your pouch. Having damaged and weakened sphincter control is not a good thing when it comes to resuming normal j-pouch function. I suppose you could give takedown a try to see if you could regain the strength and function, but I doubt it would be worth doing a pouch reconstruction for this. It's going to be a judgement call and considering what you have already had to deal with, I am sure they are not too anxious to start a new ordeal for you.

If you are seeing Remzi or Fazio, then they are the tops in experience with pouch salvage. You may want to consider a Kock pouch if the ileoanal is truely out for you.

Jan

Dear jan;

Thanks again i always appreciate your inputs.