I had my take down in August 2002, and only a few bouts of pouchitis since then (two in the first year). For the past few weeks I've been having cramping sensations in my abdomen--mostly the middle area. This does not feel like pouchitis I've had before, but could it be? The cramping comes and goes and varies in intensity. I just had a check up by my surgeon about a month ago and all looked well. What could this be? Any ideas? Suggestions? Thoughts?

Dear Erika,


it sound to me like the irritable pouch syndrome. When there are no abnormalities seen at the examinations and you still have bowel complaints like diarrhea, cramps or pain the diagnosis irritable pouch syndrome can be made. This is no serious disease but it is just frustrating and a need of staying home can be there once a while. The IPS is a relatively new diagnosis and therefore often not made by phycisians: it exists since 2002. It looks like irritable bowel syndome (= IBS)(=spastic colon) for people with still a large intestine inside. Medicine thinks that there is an oversensitive pouch/small intestine which causes abnormal peristaltic movement of the bowel, which causes the complaints. At the moment there are different possibilities to treat it, but there is still investigation under way. Imodium, different spasmolytica and tca-antidepressive agents are possible medicines (all in low dosages). An important thing is that you have to know that the bowels are just a little overactive and you don't have to be concerned about a serious diseas you have. Only if complaints change or you have for example blood in the stool than something else is going on and you need new examinations. This following link will help you to get more insight:

http://cms.clevelandclinic.org/digestivedisease/documents/POG_2003_Fall.pdf

for your surgeon this could be something to
read:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retri...003434&dopt=Abstract

and

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retri...393238&dopt=Abstract

(I'm sorry I can't sent you the full text of these 2 articles at the moment : please remember me if you like to have them).

It could also be interesting to read my topic on the discussion board about "exercise induced pain and diarrhea-irritable pouch syndrome".

Greetings and succes!

Roger