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Saw a gastro dr. today about my bowel obstructions and possible fisula. He will be reviewing my numerous CT scans but said there was nothing to be done regarding the bowel obstructions due to my extensive scar tissue. He said surgery to reduce the scar tissue would just create more scar tissue! As for treating the fistula if it's due to inflammation or infection meds may treat it. If there is an actual perforation then only surgery will fix it.....creating more scar tissue! I asked him how many times can a j- pouch be repaired and he said he was afraid I may have to face the fact that I could lose the j-pouch but even with going to a colostomy there was no guarantee I'd not have bowel obstructions anyway. Really?!? So, I guess I'm doomed to have bowel obstructions the rest of my life? I also asked about the fistula affecting the bladder as I've had numerous UTIs in the past few months and he said it could just be the stool backing up from the vaginal fistula causing it to enter the bladder (I think that's how he explained it). I have to wait until I hear back from him once he reviews the scans but I have no idea what to do. I don't know if I should just go to Cleveland Clinic and see what someone there can do, just live with the fistula once again (prior fistula I had I lived with it for 2 years before repairing by Dr. Fazio at CC) give it up and go to colostomy.....I'm so tired of dealing with this! The dr. I saw today worked with Dr. Fazio at one time so I do respect and trus that he knows what he's doing. Told me I had the best of the best when I saw Dr. Fazio....it's just too bad he retired! Sorry this is so long but I just feel like everything is going to hell with my health and I have no idea what to do or how to fix it!!
Oh yes, and to top it all off he thinks I have a hernia, too! Wonderful, just wonderful!

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I am confused by your post and maybe if you provide more information others can offer advice.

If you have inflammation has anyone determined what may be causing it like pouchitis or cuffitis? Do they know if you have a perforation based upon your scans?
Do you know what caused the prior fistula? Have you had other tests like a pouchoscopy versus scans to see if there is inflammation in your pouch?


I never like the answer that they cannot help you when they have not determined the root cause of your problem or have not offered further tests to get to the bottom of it.
J
Sorry the post was confusing. Posted it just after getting the news regarding possibility of losing pouch....very upsetting! I have had my pouch since 1996 & with the exception of the bowel obstructions & the fistula repair, I have had no major problems.
I have since heard back from the GI dr. He said there is a complex fistula between the pouch & top of the vagina. He suggests going back to CC to have it dealt with. As my husband will be meeting me there from Alaska, I can't decide whether to just make an appointment with Dr. Remzi or with Dr. Shen. Since I know it's a fistula not sure if there's any point in seeing another GI. I don't know if anyone has had any real luck in treating a fistula with meds. I'm guessing if I see Dr. Remzi & he doesn't think surgery is necessary then I'm sure he will advise me accordingly.

Thanks for responding. If you or anyone has any other advice or suggestions I will be thankful for them!
A

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