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Been having bad problems with gas and some straining. Surgeon did a scope and found cuffitis and some pouchitis. She said first we will try me back in VSL3 DS twice a day and canasa supps at night before bed. I also take 1 cipro and one flagyl at bedtime. Also started another flagyl in the morning. My concern is if this doesn't work she said she wants to take more rectum out because she left a good bit in there...I looked back at my notes and she said that I had 3cm of rectum...that doesn't seem like alot..I'm scared that if she takes more rectum then I will have leakage issues but I also can't live like this with bad gas problems making me go to the bathroom all the time! All the time! So frustrated and upset. Does anyone else have less then 3cm of rectum or have leakage issues if less then 3 feel lost with this mess

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Typical rectal cuff is 1-2 cm. you can also try hydrocortisone suppositories.

You're not taking any NSAIDs are you? They really caused my cuffitis to flare.

You may want to get a second opinion about pouch advancement surgery. Could be a good thing, but I would want someone who is very experienced with this.

Jan Smiler
Jan Dollar
HC suppositories are anti-inflammatory. They may work when mesalamine does not or if there is intolerance/allergy.

You do need a rectum for j-pouch construction, but they remove most of it in the process. If you have low rectal cancer or high grade dysplasia, they have to dissect closer to the dentate line (where the rectum transitions to the anus), but the risk of damaging the nerves of continence is much higher. The same is true if a mucosectomy (removal of the mucosal layer) is performed.

Jan Smiler
Jan Dollar

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