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Flexible sigmoidoscopy / pouchoscopy
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posted
My new doc just recommended that I have a flexible sigmoidoscopy because he thinks I likely have pouchitis. Is that the same as a pouchoscopy? I dont have a sigmoid colon, so a "sigmoid"-oscopy, I'm guessing is a bit of a misnomer for what is going to happen in my j-pouch. It's Dr. Trevor Winters at Stanford Digestive Health, so I'm guessing he knows what he's talking about (I sure hope!) Maybe they just using the same scope for the pouch as for the flex sig? Any knowledge out there on the difference? Also, am I anesthetized for this? I remember having a flex sig when I did have a colon and it being very painful due to my inflammation.

And finally, does anyone have a recommendation for a GI doc who has skills and expertise, generally knows their stuff and knows it well specific to j pouches, and could do this procedure in The Seattle area?
 
Posts: 25 | Location: Bellingham, WA | Registered: August 31, 2012Report This Post
Picture of mgmt10
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I had my first routine annual pouch scope this past July. The scope he used looked just like the flex sig scope I have had I the past when I still had UC. I had no prep or sedation. It didn't hurt at all...a bit uncomfortable of course. It was also very quick. It was cool to see the inside of my pouch on the screen.

Hopefully it wont be too uncomfortable for you since you may be dealing with pouchitis but I don't think it will be too bad. Good luck.


Marianne

DX UC (pancolitis) 2005 when I was 37-Family history of UC
Tried every drug and diet....all failed
Step 1- 6/25/10 (Laparoscopic restorative proctocolectomy with temporary diverting loop ileostomy)
Step 2- 10/8/10 (take down)
Very pleased with my results.
 
Posts: 2607 | Location: NJ | Registered: September 10, 2010Report This Post
<Dog Day>
posted
I just had one last week using what my doctor called a "Endoscope." (see pic below) The exam didn't require any sedation either and lasted for about 10 minutes. At first I thought it was going to be very uncomfortable, but he only stuck the thing maybe an inch or 2 up me, or not nearly as far as they do when they give you a Colonoscopy. My only problem with the exam is when they shot some air up me and my stomach felt bloated but it returned to normal in less than a minute. In my case I could have got by too by drinking almost anything, clear liquids only weren't needed. Thus I'd rate this exam much easier than a Colonoscopy.

 
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He actually is using the wrong terminology, though it will essentially be the same thing as a flexible sigmoidoscopy.

A portion of the Colon, the part closest tot he anus is called the sigmoid colon. Hence, flexible sigmoidoscopy. If you have no sigmoid, it will be a pouchoscopy.
 
Posts: 83 | Location: Madison, WI | Registered: August 07, 2012Report This Post
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I had a flexible sigmoidoscopy, I rated it as the worst fifteen minutes of my life. However, a pouchoscopy may be much easier going. I just remember the highest form of discomfort, the feeling of wanted to fart the biggest fart ever and not being able to.
 
Posts: 83 | Location: Madison, WI | Registered: August 07, 2012Report This Post
Picture of vanessavy
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I get flex sigs of my BCIR


Diagnosed with FAP 9/11. >100 polyps/stage 1 cancer. Cholecystectomy, Proctocolectomy and BCIR surgery December 9, 2011
7/2012 severe dysplasia returned in duodenum. beat that with light. truckin' along!
My blog: http://www.arsetopia.com
 
Posts: 1298 | Location: Philadelphia, PA | Registered: September 24, 2011Report This Post
Picture of Jan Dollar
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They call it a sigmoidoscopy because they use the sigmoidoscope. The photo in the postabove is a colonoscope, much longer than a sigmoidoscope, butthe same concept.

They call it a sigmoidoscope for scheduling purposes (so the right equipment, room, and staff are reserved), not because he thinks he will be scoping your sigmoid colon.

Should be no big deal. I've had one every year or two since my surgery in 1995. Never had sedation.

Jan Smiler


Take a deep breath and relax; this too will pass.
 
Posts: 22646 | Location: Fremont, CA, USA | Registered: April 07, 2000Report This Post
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A very big thank you to all of you for your responses. The doc at Stanford said it would be his preference that I do it there, so he knows someone with skill and good knowledge of a j-pouch is doing the procedure. But, problem is, my flight leaves to go home to Seattle in 6 hours (I came down special to see a short bowel doc) and he can't see me until Friday to do the scope. (That means missing work and paying for a very expensive hotel room for 3 more nights). I'm going to see if I can find someone skilled in Seattle, and if not, fly back for a day to have it done. Any advice on what I should ask regarding skill level as I look around the Seattle area? I'm seeing a new GI (Dr. Kalle Kang) next week and a surgeon who does a lot of pouches said he sends a lot of his patients to him, so I'm hoping he would be highly skilled in this way.

My symptoms aren't bad right now, just feeling a bit inflammed in the pouch area. Two or so weeks ago, I was feeling much less comfortable but its improved.

Thanks again!!
 
Posts: 25 | Location: Bellingham, WA | Registered: August 31, 2012Report This Post
Picture of SallyJPouch
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Can anyone tell me if it was customary to be scoped throughout your pouch and a couple of feet into your small intestine (aka signmoidoscopy) that I had a month ago. From what I am reading, it sounds more customary to just scope "the pouch". I was at a County facility and am not sure how experienced they are with j-pouches. Sally
 
Posts: 160 | Location: California | Registered: September 29, 2012Report This Post
Picture of CTBarrister
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Sally,

When I am scoped, they scope the pouch and go a little ways up my ileum above the pouch. In my case I have inflammation in my ileum above my J Pouch due to a narrowing of my bowel at the pouch inlet and resulting fecal stasis. I believe it is prudent to inspect the ileum to determine if there is any evidence of inflammation, if inflammation is present in the J Pouch. If inflammation is present in the J Pouch I would say it is arguably malpractice not to peek at the ileum above the pouch, as Crohn's could possibly be indicated in cases of chronic inflammation.


CTBarrister
UC - 1972 as a 9 year old
Takedown 1992
Chronic Pouchitis Onset 1995
Still J Pouching 2014
 
Posts: 3029 | Location: Connecticut, USA | Registered: April 12, 2007Report This Post
Picture of Jan Dollar
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My GI always goes a bit beyond the pouch itself, just to make sure there is no pre-pouch inflammation, polyps, etc.

Jan Smiler


Take a deep breath and relax; this too will pass.
 
Posts: 22646 | Location: Fremont, CA, USA | Registered: April 07, 2000Report This Post
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I have had a few scopes - not painful unless the pouch is inflammed but not unbearable and rather quick- the pouch is not that big after all.


Ulcerative proctiits progressing to Ulerative colitis since around 2000.
Laparascopic colectomyand J pouch formation covering loop ileostomy Nov 2011 at age 53
Takedown Jan 2012
Stricture July 2012
Now seem to have joint problems -under investigation
 
Posts: 51 | Location: UK | Registered: July 21, 2012Report This Post
Picture of SallyJPouch
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Thanks for the input. That helps to know it was in the norm. Sally
 
Posts: 160 | Location: California | Registered: September 29, 2012Report This Post
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