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So I finally gave up on my local GI doc and went to see the guru master Bo Shen. After a painful pouchoscopy without sedation today the diagnosis is afferent limb syndrome, which means agulation at the pouch inlet with afferent limb prolapsed into it.
Looks like the options are resection of angulated bowel, pexy of pouch to the sidewall, or pouch mobilization and bowel fixation.
Has anyone had this same issue and undergone any of these procedures? Should I expect a temp illeo will be needed?

I'm in shock.

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I'm pretty sure that was what I had before I had my pouch revision. It was a case of the part of the pouch that was attached to the small intestine was so stretched out and/ had grown so big, that it would kink and cause obstructions.

The doctor took off the huge extra part of the pouch, the size of a basketball, and reattached the sm. intestine to the healthy normal part that was already attached to the rectum. So no ileo. The expected stay in hospital was 5-7 days but I was released earlier because I got up (not during surgery Big Grin) and walked quite a bit and got the system working quickly. It was very worth it! Jpouch is working so much better now.
T
Update:
I had the surgery as planned last week. They fixed the afferent limb/prolapse/partial obstruction by pexing the pouch and the afferent limb back into place. I only hope it lasts. Luckily for me (I guess) they didn't need to re-sect the pouch inlet as they had expected, and also I was pleased to wake up without a bag (as expected). The hospital stay was 4 days, so I came home Sunday. I have been suffering from bad nausea and no appetite, and lots of abdominal bloating and cramping. It seems to be slowly sorting itself out now, and I started eating a bit yesterday. I really forgot how horrible these recoveries are, which is probably just as well because I wouldn't have done it otherwise! Just weighed myself and have lost 3.5KG in 6 days.
kiwiPouchnUSA

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