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Hi Everyone,
I will be having my first scope since my j pouch surgeries 2+ years ago. For most of this time I have had little difficulty with my pouch provided I am careful with my diet, exercise regularly and stay healthy. I have been taking 1-2 Immodium in the evening and with that dosing would have a manageable 2-4 bathroom trips at night. Quite suddenly, however, something has really changed and I have been significantly blocked up. I had a partial bowel obstruction 2 weeks ago, very scary, and that took 10 days on a liquid diet to resolve. Since then I have been straining with difficult, slow moving bowels. Yikes, very different from what I had grown used to! By way of suggestions from this site, I started taking VSL#3 and MOMs at night to keep things flowing and find a new balance with diet and meds. It has helped. In other posts I was told that I should be checked for a possible stricture somewhere; or, that my pouch may have matured at 2 years out and this maturing combined with a low dose pain med I take daily (for chronic neuropathy) may be why my bowels have gone from the "normal" j pouch loose to thick and kind of stuck feeling. Both things seem like reasonable explanations for the changes I am experiencing. Fortunately, I have my first scope and rectal exam coming up so things will get checked out. My question today is about the prep for the flex sigmoidoscopy. I have been instructed to drink 10 oz. of mag citrate the evening before and then give myself 2 saline Fleet enemas an hour before the procedure. As this is my first scope w/out a colon, I am wondering if this seems like the normal prep for a j pouch? I have a new surgeon who will be doing the procedure as my take down/construction surgeon sadly has retired. I trust and like the new doc but don't know him well and he didn't "make" my pouch so he is not familiar with me in that way. So, long message, sorry, but does this prep seem like a normal prep for a poucher? Thank you.
Best,
Savannah
2005 Dx UC
2009 ruptured colon total colectomy/ileostomy
2010 two stage reversal and j pouch
2011 Spinal cord injury and decompression surgery dx: Central Cord Syndrome (restored motor functioning after paralysis but chronic neuropathic pain in my limbs)
I have generally been doing quite well and I always learn something helpful from this website!

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I do take the mag citrate, but not sure how necessary it is. Mostly, it is because I do not want to be on clear liquids all day on the day prior to the exam. I take 1/2 bottle and if I don't feel cleared out by that in a few hours, then I take the other half. Like you, I take some daily opiates, so I want to be proactive and get good and cleared out.

With your recent partial obstruction, go easy. So, definitely do not chug the whole bottle of the mag citrate. Maybe 1/4 will be enough. Then be sure to drink plenty of liquids to follow up.

As for the Fleet enemas: my doc prefers that I do tap water. I buy one Fleet enema, instill it, but do not hold it more than a few minutes (basically just rinse). Then I refill the bottle with tap water and rinse until clear. The reason for the tap water over the saline is that the concentrated saline can be very dehydrating. If you hold it long enough, it pulls a LOT of water from the bowel wall.

Jan Smiler
Jan Dollar
Thanks so much Jan and Lisa. It is so good to hear others experiences to compare with my own. I think I will go slow and easy with the mag. citrate and with the enemas. It would be stupid to worsen things with a prep! I will let folks know what the findings are after my scope. Hopefully, everything is OK with the pouch and it is simply doing its job more efficiently at this point. I do wish I could manage without pain meds for another chronic condition. The meds complicate matters a little in adjusting to the pouch.
Savannah

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