Hey everyone,

I had UC and had my colon taken out in November '04. I then had a J-Pouch created November '05. The past few weeks I've been having to take a bowel movement nearly every hour and a half/two hours. Also new is the urgency, even if there is not much to empty, I feel a lot of pressure. When I have the bowel movements my anal muscles feel really strained and put out. This has also caused quite a bit of leakage at night, which is very annoying. Any suggestions to diet I should take? Or conditions this could be? Also what medications and doses would I be put on? Thanks for your help guys.

Hi, I am new to this as well. I had a J pouch put in one go , in April '06. I can well empathize. I will share my experiences and tactics. I don't know what works for others. First, the strain and urgencies bring about hemmheroids. Not pleasant. A plastic sitz bath ,(available at a pharmacy) with hot water, can ease the pain and relax the annus. I don't moind even ****ting into the hot water as it empties the pouch without strain and gives some relief for a little while. After 2 moths on antibiotics the infection is still there, so I experience urgencies , spasms and pain until I go back on Antibiotics. I try to eat my meals earlierin the day so I can hopefully get less interruptions in the night. I still wake every 2 hours , at best. Sometinmes I get 3 or 4 . Psyllium husks seem to thicken the stool and make it less liquid. 'Sanitary napkins kept in the crack or stuck to underwear at night can help contain possible accidents.
I hope this helps.

Hi Subsky,

it looks like your pouch is not functioning like it used to. The first two things that come in my mind when I read that you're having urgency and more stools (without blood) are pouchitis and the irritable bowel syndrome. To get it clear what is going on, an endoscopy with biopsies of the pouch are indicated. Is there inflammation to be seen you have a pouchitis and have to go for a temporary antibiotic treatment like Flagyl or Ciprofloxacin. If there is no inflammation visible the irritable pouch syndrome is most probably the case, which can be treated with Imodium, a spasmolytic agent or a tca-antidepressive agent in low dosage. (a combination of both problems is also possible causing your problems, though to me not very likely). To exclude a bacterial infection, your stool has to be controlled to.
So contacting your doctor would be my advise.

Succes and greetings,

Roger

It would be smart to get checked for an anal stricture also by digital (finger) rectal exam. Frequent trips with little output are symptoms of this. If there is a stricture and the pouch is not emptying, then you can get bacterial overgrowth and inflammation in the pouch, which can be treated with meds. If you ONLY treat it with meds though, and there is a stricture, you will most likely continue to have the problem.

A stricture is just a narrowing, in this case, of the anastomosis site caused by scar tissue. It can happen at any time. It is treated by dilation where they break the scar tissue. Sometimes it can be done in the office, sometimes under anesthesia. Sometimes one dilation fixes the problem, sometimes it must be repeated.

Chances are, if you take pouchitis meds, it will improve, but get the digital rectal exam as soon as you can to rule out a stricture.

Keep us posted!
Lori

I totally agree with LHipp. Another more seldom complication of the pouch in your case could be
a pouch prolapse. Prolapse symptoms include external prolapse of tissue, sense of obstructed defecation, seepage, and pain. Your phisician can find out. This complication however needs surgery, but has a good prognosis.

Greetings en succes,

Roger

This message has been edited. Last edited by: kangaroo-roger,

Hi Subsky,

Yet another possibility is cuffitis. More about that under the following link on page 3:

http://cms.clevelandclinic.org/digestivedisease/documents/POG_2004_Summer.pdf

Greetings, Roger