I'm thinking about asking my surgeon to perform a scope of my pouch to check everything out. I'm wondering two things. First, is scoping pretty safe or is it likely to cause further injury/trauma to an already painful rectum that may already have a fissure. I mean if I get scoped is it likely to make the fissure worse especially if the dr. finds an anal stricture and dialates it?
Secondly - if I have no pouchitis, could the scoping itself introduce bacteria into the pouch and cause pouchitis? I know this is hard to answer for sure but I'm wondering if anyone here has had pouchitis that they think could have been caused by being scoped.
Thanks
Ted.

Scoping for no reason at all is not recommended because it is not without risk. The primary risk is of perforation, which is rare but real. Scoping can precipitate inflammation, but not by introducing bacteria. The scopes are sterilized between use. The risk of inflammation is due to the trauma and manipulation. Again, this is rare, but real. If you have a known fissure, it makes sense to deal with that first before getting involved in invasive procedures that could potentially worsen things. I suppose dilating a stricture when a fissure was present could make it worse, but probably not. I would suggest that you discuss this with your doc and decide together how best to proceed

Thanks once again Jan - one other question if you don't mind. Say I do have pouchitis, and I wait until it can be confirmed by scoping to actually treat it. At this point my symptoms are mainly anal pain and spasms - painful but I can certainly live with it for a month or so while I determine if the ointment fixes it and therefore it's probably a fissure. So let's say it turns out ultimately to be pouchitis and I start antibiotics in a month or so. Will the fact that I waited longer to treat the pouchitis make the pouchitis more likely to be resistant to treatment with antibiotics or more likely to recur once treated? I guess what I'm asking is: does putting off taking antibiotics for pouchitis (if your symptoms are tolerable) make it likely that the pouchitis will ultimately be harder to cure/treat? Is there any danger to the long term health of the pouch by living with pouchitis for a while rather than treating immediately?

Thanks Jan for your continued advise and support!
Ted.

No, you should be OK. If it is pouchitis and you do not treat it right now, you will soon learn that you need to treat because your symptoms will worsen and you will be miserable. Waiting a few weeks shouldn't make any difference in the long run. You could go ahead and take antibiotics just to be on the safe side though.

Plus, the symptoms you describe are not typical for pouchitis. They could be related to pouchitis, but unless you have the hallmark symptom of diarrhea, you probably do not have pouchitis. I'd wait and see if the fissure treatment resolves your issues before demanding a scope. Talk it over with your doctor and see what makes sense. He may ask you questions that you didn't think of that could help him and you decide what to do.

Jan

Cool - thanks Jan - unfortunately I do have diarrhea but I've pretty much always had diarrhea since takedown. I guess things are more watery now but I figured since these spasms are making me go twice as frequently that it's just because the stool isn't staying in me as long to have as much water absorbed.

Sometimes it is difficult to separate the symptoms... I can understand your frustration.

Jan

my son had a perforation. It's scary stuff!