I'm getting my first pouch scope in a week. I've searched past posts and it looks like doctors go anywhere from enemas to no prep for the test. I'm afraid the surgeon won't be able to tell what is wrong as I'm not to do any prep.

Do they give you any medication, this is being done in his office?

Do they use water to clean out the pouch so they can visually inspect it?

Will I be able to see it on a screen like I watched during my colonoscopies?


I've had tests, antibiotics and tried everything to get rid of the pain. I have tried all combinations of fiber, immodium, pepto bismol and digestive enzimes plus I take VSL#3DS daily.

What happens if he doesn't figure out what is causing the pain?

My internist has ordered several tests and nothing in the tests indicated what the problem was plus I took a course of flagyl.

Do any of you still have chronic pain even when they can't figure out what is wrong?

I appreciate your advice and don't know how I would have made it through the last year without everyone's support.

Thank you

Typically the prep for a pouchoscopy is an enema prior to the procedure done at home prior to leaving for the surgeon's office. I have never taken drugs for a pouchoscopy; I find that they are fairly quick and painless. Uncomfortable, yes, but painful, no. But every one is different. You can watch the procedure on the screen. I don't have pouch pain, never have so I can't help you there. You can try to PM Jan and get her opinion.

Sue

I had chronic pain for 3 years after my surgery. Every test or scope I had came back with nothing or they'd chalk it up to a partial blockage or pouchitis even though I knew they were wrong. This summer I tried a new doctor and hospital and bam! Diagnosed with crohn's. Not saying that is what is going on with you. Just saying to keep trying! And that I hope you get your answer soon.

As far as prep goes. At the first hospital I went to there was no prep (yay!) and I was usually awake and it was not painful.

Last time I had a scope (they were scoping further up- in through the jpouch and up) I had to do 2 water enemas in the hospital and for the scope itself I was put out.

Either way there was no pain and little to no prep!

I've had scopes in the doctor's office and at the hospital. Neither required sedation. As Sue mentioned, an enema or two was all that was needed in the way of prep. In the office, my doc could wash the area in order to see everything better. Having the same procedure done in the hospital allowed him to remove any polyps he found. He could not do this in his office. Either procedure was virtually painless and over in just a few minutes. Watching it on the monitor was very interesting.

Whether or not you will be able to watch on a monitor depends on the type of scope used. If it is a flexible fiberoptic, then yes, there will be video monitoring and snap shots taken for the record. But, if it is a rigid sigmoidoscope, no TV monitor. Thankfully, thatt barbaric rigid scope is not used much, but there are still some surgeons who use them. Regardless of the type, they can use water to flush out any stool that is present.

You would know if you were being sedated, as they need to tell you to arrange for transportation. You can't drive after sedation. If you want sedation, you need to call them and make sure it is set up in advance. You do not want to assume you can request it on the spot or you may have to forgo it or cancel the scope and reschedule.

What happens if the cause of your pain is not evident on scope? Well, they can do CT scans to rule out abscesses or other problems going on outside the pouch. But, sometimes they just never know for sure. If they rule out all the typical causes, then you are left with adhesion (internal scar tissue) related pain, entrapped nerves, and similar issues that defy all tests. And yes, sometimes it is something like Crohn's that is very difficult to diagnose.

Jan

Thank you everybody. They did a CT scan but that was before the hernia came into the picture. My internist offered to do another but I elected to wait for the scope. Since I had a big abcess they had to remove under my incision and another that she caught on the surface and drained it is possible that I have developed one internally. So if he finds nothing then I'll ask for the CT scan.

It better not be crohns but it's a good idea to ask. I had a 2nd opinion, from Mayo's in MN, and they diagnosed me with UC. That was over 10 years ago, it could have evolved.

The radiologist told me scar tissue and adhesions don't really show up on any of the imaging I've had done. I guess that's to "go to" when they can't figure out what is wrong.

Thank you for your support. I know the pain is real. I'm going to a counselor for my mental issues and imagining pain isn't one of them.

Jan I think I remember that you take pain medication daily but it's for a bad kind of arthritis and not pouch pain right?

Inflamed and untamed did you take pain medication the entire three years before you received your corrected diagnosis? (I love your video's on hair extentions BTW - as I might need to do that soon too.)

Thanks everybody, my husband is coming with me and I'm going to take a xanex as my anxiety is pretty bad. The last time I got bad news and had to drive home myself I almost got in an accident as I was crying and my mascara was running and burning my eyes - what a mess. I hardly wear it anymore, especially if I'm driving, lol. I don't go anywhere anymore either. Saving a lot of money on cosmetics these days, lol.

You all are the best

Yes, for arthritis, not pouch issues.

Jan

I was just at my surgoen's last week for a follow up. He told me to come back in july for my first scope. Nothing was said about a prep and I'm silly for not asking. My sister just had her pouch scoped a couple of months ago and she said she had no prep. Her dr. was suctioning stuff out and spraying water in as he was doing it. She got to watch on the screen. I'm sure all docs are different with how they do things.

No, I didn't take pain meds the entire 3 years. I tried to tough it out most days because I am not a fan of being on meds. Some days that was impossible though, and sometimes (I imagine now when I was in a flare-up from crohn's) I would go to the hospital because I just couldn't take it.

Thank you for liking my videos too by the way. I am glad they help.

-Sara

Thanks mgmt10, it appears as I'll be getting scoped like your sister. It just seems messy tp me.

Inflamed, I don't want to be on pain meds as they all make my vision a little blury plus I just don't want to be one them. I can't tough it out so by late afternoon I'm in pain land and have to take them. You are one strong gal!

Toughenough...

At my scope today (under anesthesia), the surgeon was able to go a fair amount up into my small intestine as I have been complaining about left sided pain. He also performed a dilation at the anastomosis and biopsies of my pouch and above it.

I guess the first step is what you are going to have done which is normally done in the office with no sedation or prep and yes you can watch on the screen. If this does not find the cause of your pain,they will either do more scoping under anesthesia or possible upper series tests.
Good luck I hope you feel better.

Inflammed...I love your videos too and think you are beautiful! Do you mind if I ask what type of pain you were experiencing and symptoms you had prior to crohn's diagnosis as I did get tested for crohn's today with my biopsies. I am a bit concerned as my old GI doc once referred to me as having crohn's colitis and later told me he made an error and I really had UC (25 years before jpouch). The upper left pain has me a bit concerned as I told the surgeon today it feels inflammatory in nature and although they looked at a lot of intestine above the pouch, they obviously could not view it all.

What tests did you have that finally diagnosed crohns for you. I know you are on remicade and hope that is working for you. Without it are you in pain and also have pouch issues?

kjeane,
I just read about your scope today and I'm having the in office no medication kind. I've already had the small bowel barium series which didn't indicate any problem sources. I think I have a problem up at the top of the pouch, scar tissue or whatever that is causing my pain but really don't know.

I am glad you are going to have more answers soon and your scope was pretty good too!