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Help! Need advice now!
Pouchitis or cuffitis...?|
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Can anyone give me descriptions of both?
And...how are they diagnosed? Have a fabulous day! UC...1985 Step one...Aug '06, Takedown...Dec '06 Emergency SBO Surgery...Oct '07 Jan '08 Bartholin gland removed, kidney stint placed Oct '08 diagnosed w/ Crohns Nov '08 Seton drain placed |
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This is my interpretation. Pouchitis is an iflamation of the pouch, symptoms being increased output, urgency, feeling flu-like, cramping. Cuffitis is an inflamation of the retained rectal cuff (not everyone has one), symptoms being much like pouchitis except for blood, the feeling of incomplete emptying, and a burning sensation. My daughter has had both and with cuffitis, the burning pain was the worst. Pouchitis is treated with antibiotics. Cuffitis is treated with UC meds and suppositories. Hope this helps.
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Forgot about the diagnosis part. Sometimes the Dr. just starts someone on antibiotics and if they help, it is considered pouchitis. If it doesnt help, then a scope is needed and that will show inflamation of the pouch (pouchitis) or they will see inflamation of the cuff and that will give a definite diagnosis. Some Dr.s can put their finger up and feel the cuff area and if it is bumpy to touch, they can usually tell if it is cuffitis. But the best way is to do a scope.
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Just a little adding in other words about the cuffitis: it indeed depends on the operation you have had if it is possible to get cuffitis. Two types of ileal pouch-anal anastomosis have been described: 1) a mucosectomy of the rectal stump followed by a hand-sewn ileal pouch-anal anastomosis (there is no mucosa left when it is done well enough) and 2) a stapled pouch-anal anastomosis technique in which a small part (1-2 centimeters) of the rectum stump mucosa has to be retained to make the connection with the pouch. This mucosa part is at risk for developing cuffitis (or dysplasia), because it is a remnant of the disease. Thus only people undergoing the second technique can develop cuffitis. A Typical feature of cuffitis is the bleeding, this must not typically occur when having pouchitis.
You may wonder why we not all get operation 1? Or whether operation 2 is an older operation. The answer is that both operations have its pro's and contra's, so in medicine there is a lot of discussion about and both techniques are used. Greetings, Roger -Why can’t they just leave us alone?- |
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Thanks Stell & Roger....
I seem to have all the symptoms, but very little bleeding. Mostly just feeling bad and tired. Have a fabulous day! UC...1985 Step one...Aug '06, Takedown...Dec '06 Emergency SBO Surgery...Oct '07 Jan '08 Bartholin gland removed, kidney stint placed Oct '08 diagnosed w/ Crohns Nov '08 Seton drain placed |
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Just my 2 cents here
I have both... I never knew I had pouchitis until my 2 month scopes (i have dysplasia in the cuff so I go every 2 to 3 months till we figure out the progression). A lot of ppl have the cramps and runny BMs and sometimes accidents with pouchitis... I had none. I take 250 mg cipro for it every day and no issues (also vsl3) Now, the cuff is a different story. I knew I had it for a few reasons: 1. Saw blood now and then 2. I would have spasms and contractions in the cuff area that would kill me and come and go whenever they wanted. I knew it wasnt from my pouch because the pain was def coming lower. My Dr put me on 1000mg rowasa and within 2 days I havent had that feeling again (Dr also on the scope saw my cuff inflamed). I am now on 500 mg once a day rowasa suppositories and never had a spasm/blood/contractions again. So, to me the spasms in the cuff area def was much different from the pouchitis Good luck, you are always so wonderful with ppl here and you deserve to feel better! Jason Jason - Pa statie7104@yahoo.com Step 1 Jan 06 Step 2 March 06 Spleen & Gallbladder June 06 Pouch Disconnect / End Illeo May 07 |
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Dear Cataja,
I would advise to make an endoscopy, certainly when you tell there is also blood in the stool. They can find out if it is a pouchitis or a cuffitis and give you a proper treatment (a 2 week antibiotic-course for pouchitis or some mesalazine-agent for cuffitis). I can imagine that this is a disappointment after a pouch surgery, but I can tell you (there are of course always exceptions) these problems are minor in contrast to what that "nice" large intestine could bring you. I hope (and know) you will be fine soon! Greetings and best wishes, Roger -Why can’t they just leave us alone?- |
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Thanks everyone. I'm going to see my surgeon for a pouch scope next Friday. He will decide if they need to check my gall bladder or anything else. Hopefully we will get this figured out. Thanks again.
Have a fabulous day! UC...1985 Step one...Aug '06, Takedown...Dec '06 Emergency SBO Surgery...Oct '07 Jan '08 Bartholin gland removed, kidney stint placed Oct '08 diagnosed w/ Crohns Nov '08 Seton drain placed |
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J-Pouch Community
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Help! Need advice now!
Pouchitis or cuffitis...?
