My husband had a J pouch put in 1982. For the last few weeks he has been cramping about 2 hours after he eats. It is getting worse and very painful. He points to the left side about waist high when he describes it.
Suspecting pouchitis, he took antibiotics, with no success. Went to the gastro doctor, did a lower GI and CAT, could find nothing. Will be having an upper GI done tomorrow with the barium. Has anyone had similar symptoms that might shed some light on this?

Could easily be a kink from adhesions. I get partial obstructions rarely from time to time and I am more than a decade out from my surgery.

Jan

Hi Jan, and thanks for the quick response.
I am new to the website, and truly a newbie. A few basic J- pouch questions I hope you might be able to answer:
What is an adhesion?
What causes an obstruction?
What is a stricture?
What is a fistula?
Are any of these preventable (by good habits)?
Sorry to show my ignorance, but I was unable to find a good definition for these as related to J-pouches.
Thank you!

Adhesions are when there is a union of adjacent tissues, so like your scar tissue and your intestines. My understanding is the scar tissue is ever evolving and being that your bowels are also always moving, the scar tissue can form a union with the intestines and actually kink it off, which answers your next question.

Obstructions can be caused by scar tissue wrapping around the small bowels. Some people will say that for them obstructions could also be caused by eating certain foods or by stress. I have been told by doctors there is nothing I can do to prevent or cause an obstruction or blockage. There may, however be things you can do once you have one.

A sticture is an abnormal contraction of a passage or duct of the body. So I think of a narrowing of a duct that doesn't allow normal passage of contents.

A fistula is a narrow passage (in my case, it wasn't so narrow) or duct formed by disease or injury that leads from one cavity to another. You may have read on the site about many women having a vag/rect fistula where there is a passage that has opened up between the Jpouch and the vagina and things are passing all the wrong way.

Jan will probably be along with much better information and some good links for you but maybe that helps a little in the mean time

Olive pretty much has covered it all and I only have a few things to add.

Adhesions are formed in the first week or so after surgery, so there is absolutely nothing you can do about it now. They also can be caused by internal infections (such as with a ruptured gallbladder). Adhesions are the typical cause of bowel obstructions in those who have had abdominal surgery. You cannot prevent them, just be aware of the symptoms when they occur, and know when to seek help from a medical professional. If you do a search here, you'll find lots of info about them.

People would like to believe that they can prevent them with a diet free of roughage, but that really isn't true. If you have Crohn's with a stricture causing a severe narrowing of the small bowel somewhere, you may have to limit your diet or have a bowel resection.

Fistulas are generally associated with infection or trauma. Those with Crohn's are more likely to develop them, but anyone who has had deep pelvic surgery can develop them as a result of the trauma. Usually they will develop within a few months of surgery, but there have been some who developed them years later.

So, unless your husband has been eating glass or carpet tacks, he probably has been following a fine lifestyle to be able get along so well since 1982. I am sure he could teach us a thing or two!!

Jan

Hello girls, and thanks so much for the input.
We have recently had the lower GI done and nothing shows. However, the cramping is still heavy for him, and things are not moving through much(due to the fact that he is taking the Lortabs to make the pain somewhat bearable). What is most frustrating is the doctor is being really obstuse and telling him to take a pain pill, but not really looking for a reason for the pain. The pain pills just constipate him and make things more painful...
Is there anything non prescription that will make the "stuff" move through?

1. Stop taking pain pills!! They can just make it worse, and aparently that is what is happenign with your husband. If the pain is severe and obstruction is complete,then narcotics may be necessary to get the gut to relax enough until the swelling goes down and things can move again.

2. He may be better off with antispasmotics and sticking with a liquid or at least very soft diet for a few days. Drink a lot of juice and water.

3. Simethicone and probiotics may help.

4. Keep moving, massage the abdomen. A heating pad or warm bath may help.

Geeze, I hate it when docs just throw pain pills at a symptom without dealing with the whole picture...

Jan