Hello, I have visited your site several times, and have found a lot of helpful information. I have recently had the j-pouch surgery. I was reconnected on January 23, 2008, but I have had nothing but problems. I was hoping maybe you could help. When they took down my ileostomy they dilated me and tore me. Where they sowed my pouch to my anus it is staying raw and bleeding, and as you can imagine this is excruciating every time I have a bowel movement. The doctor has tried me on every kind of cream you can think of, and he has tried the different diarrhea medicines and antispasmodic medicines to help me not go to the bathroom as much so this can have a chance to heal. Nothing seems to be working and the doctor is saying the only thing he know to do now is put me back on the ileostomy for a while and try and let the anus heal. Now the part that is raw is not the normal spot where I guess the skin ends and the anus begins, but rather right where the pouch is sown to the anus. Has anyone ever experienced this problem before and if so how do you get the problem to heal. If you can help oh, I would really appreciate it.
TRS

Two things come to mind - a fissure or cuffitis. For a fissure your doctor might prescribe nitroglycerin ointment. It will cause a headache for a few minutes but it goes away. For cuffitis your doctor would prescribe suppositories and/or other medications for it.

Is there any way for you to get a second opinion on this? I don't think it's time to go back to an ileostomy quite yet. And one other thing you could do is get a remote second opinion at Cleveland Clinic. You would send your records to Cleveland for their assesment. I think it costs several hundred dollars but it might be worth it if you get some answers.

kathy

Hi TRS, I'm the mother of a 13 year old with a jpouch. I couldn't help but wonder if your tear is actually pouch related. I had a fissure after the birth of my last child and tried everything to let it heal "naturally". I suffered with it for months, then had surgery to fix it. I felt better the day after surgery than I did the previous 3 months. The surgery was simple, outpatient, and worked wonderfully. A second opinion is always a good idea.
Tricia

I wonder too whether it might actually be a fissure.

Also, even if it isn't I don't see why your surgeon can't just put a couple of stitches in too keep it closed up.

I agree with previous advice that you get a second opinion. I'd be asking to see the surgeon not a doctor with this type of complication.

Thank you for your replies. I had the surgery done at the Mayo Clinic and they are the ones still treating me. I have been scoped at least 4-5 times in the past six months, and they said it is not a fissure. The surgeon has looked at me, and the GI doctor looked at me, even the dermatologist looked at me. None of them seem to be able to figure out what it is. Inside is just raw and bloody where they hooked me up. I really am thinking that it is from them dilating me. I believe that is what made me raw, and it can’t heal because of the constant use. I don’t know; it is the only thing that seems to make sense because when my bowels woke up in the hospital, and I had my first bowel movement it was like fire up inside. I considered having them put me back on ileostomy right then it hurt so bad. This is why I think it has to do with them dilating me. TRS

Hi TRS, I found this oinment called Nupercanal and it is the best I have ever used. It takes away anla pain as wll as provides a barrier. CVS and most major drug chains sell it. I beleive what you are saying about the dialation being the cause from ripping. I had jpouch surgery in 2003 and take down in 2004. I have had excruiating painful bm's and my doctor agreed to put me on Oxycontin 80mg's twice daily. It helps with pain so well but causes constipation but nothing some magnesium citrate or prune juice won't cure. I feel sorry for you because it sounds like your surgery was not so succesful if it left you with alot of agonizing moments. My thoughts and prayers are with you.

Rick

have your gi dr. look at your rectal cuff. this is where the pouch and the retum are connected (stiched together) if the tissue is the old infected tissue you may have cmv infection.