A J-pouch won't become disconnected due to contact sports. It's well protected in the pelvis. Major abdominal surgery does alter things a bit, but a well-healed surgical site and anastamosis (connection) is nearly as good as new. That being said, sometimes a flaw in the scar can lead to an incisional hernia. Full-contact MMA, Muay Thai, etc. can lead to all sorts of injuries, including intestinal injuries. If you have new plumbing then that's what's getting hammered, and that's what can get injured - not so much because of the surgery but because of asking people to try to hurt you.

 

Chronic inflammatory illness can affect your endurance and exercise tolerance. UC is a bit mysterious about what causes things to flare, but it's not astonishing that vigorous training seems to affect it. In all likelihood you wouldn't continue to have that problem with a J-pouch, since you wouldn't generally have any colonic symptoms without a colon. A J-pouch would increase your need to carefully attend to hydration when training hard.

 

I have no idea what your parenthetical list of (hypothetical?) causes of colon problems is about, so I can't comment on that.

Not sure I understand why someone would be concerned by a J Pouch injury and not others.  Did any of you guys see the Boom Boom Mancini vs. Duk Koo Kim fight? Kim is dead due to repeated blows to the head.  Muhammad Ali cannot speak due to repeated blows to his head.  Forget about the J Pouch and think about possible head injuries which could be of a much more serious and PERMANENT nature.

I am extremely nauseous for hours in the morning, always have diarrhea 4-7 times a day, BMs are painful, sometimes blood, constant abdominal pain, feel sick all the time. I goto kickboxing because I love the sport, and when I am actively doing it, I am so distracted that I do not feel the pain, but when I am idle, sitting, at work, it hurts all the time, especially the day after the muay thai.

 

I noticed that immediately the night after the training I feel like in remission, but the 2 days after I feel so much pain in my abdomen, even though it was my legs that took the beating.

 

 

Hey Scott,

 

That's great to hear I am glad that will not happen, imagine if a kick could disconnect a j pouch! Ouch!

 

For hydration, would drinking a gallon of water really fast with a j pouch cause you to have a leak or a BM? If so, couldn't you thicken it up with something like slippery elm bark to slow down the water? Hmm..

 

Hmm, That's true as well, if you were an actual UFC fighter and people knew you had a j pouch, they would aim right for the surgical sites. But for training do you think a jpouch person could train better than a person suffering from chronic UC inflammation?

 

I guess I really just want to train harder and more frequently without having to increase my UC symptoms.

I've done kick boxing with my j pouch.

 

Scott F:

I think most J-pouchers are able to train better/harder/more frequently than someone who is sick with UC. That's mostly because they're usually not sick any more, or much less sick. 

 

A fast gallon of water might run right through you. I'll pound down a full glass of water (not a gallon!), but some folks don't even tolerate that well. Water throughout the day maximizes a J-pouch's ability to absorb it. The most common additive for J-pouchers that can "slow down" the water is Metamucil. I have no idea what slippery elm bark might do.

Hey AllyKat,

 

I just read through your sig, sorry to hear you had to have an emergency surgery, your ordeal sounds very painful.

 

How are you doing now? Do you have pain like that of UC? How many times a day do you go?

 

Scott, that is so great to hear! Why were you a candidate for a single step j pouch? Did you refuse to use steroids, 6mp and biologics too?

I am so scared of those drugs!

 

Do you feel pain like UC now? How many times a day do you go? Thank you so much!

I've never been limited by my pouch.  I've worked out hard earlier in my life, with no issue, run, done yoga, etc. No, none of that is extreme like what you're asking, but I have no idea why it would limit you, once healed. 

 

I have no pain after surgery, but I also never had pain *with* UC (just tenesmus and urgency).  That completely went away. I range about 4-6 BMs a day, I'm continent, and I sleep through the night.

As a trauma ICU nurse, I'd be more worried about a head injury than pouch injury, TBH. ��

 

Also, as an aside, my daughter has experienced complete remission on Humira for the past year. Quality of life is important to me, and they know that getting kids to remission in the first year = better long-term outcomes. 

 

I'd exhaust med meds therapy before surgery. I only had steroids and Azulfidine as a kid. The options today are so much better.  Surgery isn't always an easy path, and I would say your extreme activities would equate to at least a full year off before you could get back into them. 

I tried all of those types of medications prior to surgery. If they had been adequate I would have been happy to use them instead of surgery (steroids would only be satisfactory if they did the trick with occasional periods of use, e.g. by shutting down flares). I feel no UC-like pain now. I use the toilet about 5-6 times daily, but much more important is that I have no urgency.

 

My surgeon offered me either a one- or two-stage procedure. I selected the one-stage because I had to travel by airplane to the surgeon's location, so I wanted to get it over with. I honestly don't know why he offered the one-stage. They appear to be rarely offered these days, and are apparently riskier.

It's a hard choice, surgery or toxic drugs? I personally didn't have too many options. Today, I would try diet, fecal transplant, functional medicine along with UC meds.  Surgery is not a cure all, just gives you another set of problems. I do ok considering, really, I was very very sick. I'd only have this surgery as a last resort. 

My surgeon did only a handful of one steps in the 90s. He confided in me he had one patient do incredibly poorly, and die, after a one step procedure. it left him scarred so much, he said he never did a one step after that. It's all two or three steps (mostly twos) for him, and he's been doing this surgery since the early eighties, starting out at the University of Chicago.

I think I found a hobby that I love and could do for a long time and that is muay thai/kickboxing.

On a bad day like today, I went about 7 times already, with very painful watery diarrhea, and other times just a tiny little plob the size less than a penny. Those tiny ones hurt the most to get out, I hate those almost more than the watery diarrhea because I have to strain so hard and I never feel like I had a complete BM. It's a torture that we all know too well.

I want the surgery because I believe I cannot end the pain otherwise. If I take steroids I would risk not being able to train because steroids destroy the bone. If I take 6mp I risk bone marrow suppression. If I take Remicade I risk random joint and skin diseases 30-60months down the road, which is terrible to have looming over among other risks. In order to do powerful low kicks, or any muay thai kick in general, I need to have strong bones.

Although there are days I can tolerate 4-5 semi formed, non strained BMs, there are days I cannot tolerate 7-8 bloody, painful, strained, diarrhea/BMs where I am straining on the bathroom so long my legs fall asleep.

With a jpouch I hope I would have about the same frequency or less, but with the chance that I will require less meds, have less pain, and free myself from the mental despair/anguish/obsession of UC as well as the physical pains of UC and the emotional roller coaster that is UC.

I bet there are tons of great j pouch doctors, but I think I'm in love with Dr. Tonia Young-Fadok! I think it's so very rare to find someone as beautiful AND be a leading researcher in colorectal surgery. She was the one who pioneered the single incision procedure I believe. .

You are comparing the worst possible outcome from medications to the best possible outcome from surgery. That may not get you the best answer. The actual result (for either) will usually be somewhere in between. The strongest argument for medications first is that they can be stopped if the side effects become problematic. Even steroids, which are wonderful short-term drugs but very troublesome when taken long term, can be stopped if the side effects (including bone density problems) become unacceptable to you. Surgery, on the other hand, can never be undone, even if the result is terrible. It's true that a problem pouch can be removed and replaced with an ileostomy, but that's a much bigger deal than stopping a medication.

 

I'm very happy with my J-pouch, but I think it would have been a poor decision if I hadn't tried medical options first. To keep my pouch functioning I have to take two antibiotics every day, and the nastiest possible side effects of those are pretty ugly, too. Just sayin'.

I think if medical therapy had been more extensive when I was a child, I would have totally exhausted it rather than go to surgery at age 19.  While things have been good (great for 20 years), the new issues I'm having are what they are, and I'm on some med therapy even despite the surgery. 

 

You can't always predict an awesome outcome... it's all a Roulette game, in my opinion.  Some patients who look like great candidates for surgery have difficult post ops... some don't.  Some people have issues with med therapy, and some cruise along. 

 

You just have to find what your tolerances are, what you'll accept, and go from there. 

 

But again. If I had the option for biologics back in "my day," I would have gone there in a heart beat. 

 

 

I tried the biologics, diet, surgical fecal microbial transplant, you name it, before having surgery. I believe if I hadn't, the "what if" regrets would be too much. As it is, I still get tangs of them sometimes. That's when I appreciate getting reminded that I was 85 lbs and dropping, too weak to shower myself, etc. 

Some people can't understand how I suffered so long, but speaking for myself, I needed to explore all options first. No right answers, so I wish you courage and wisdom!

I regularly do boxing training and have sparred many times with my trainer although he knows not to punch me in the abs.

 

but this was with an ileostomy and the stoma sticks out so is vulnerable to getting hit.

 

I just had takedown a week ago and im planning on boxing again once I've fully recovered. I'm pretty sure I will spar again but then generally you don't get punched in the pelvic area in boxing as its too low. im not sure about mma though

I'd also like to add I had UC for 13 years, decent periods of remission and periods of regular flare ups.

 

I did very well on infliximab (remicade) for a while, but then the NHS stopped paying for it and after that I had regular UC flares again

 

After being hospitalised with a really bad flare in December 2013 they approved another course of remicade but I had a bad reaction second time round. there wasn't much else to try now medically as I wasn't responding to IV steroids either.

 

I was in a bad way, although it wasn't an emergency case yet, but Christmas was approaching and the GI docs thought it was best to go for the surgery now and not risk needing emergency surgery over Christmas where the best surgeons would have probably been on leave and be at the mercy of the covering surgeon.

 

 

I'm still hoping I can return to full activity sports like was before. I'm a baseball player that is a balls to the wall type. Diving, sliding, smacking into walls to make a play. A lot of times it was tough when I was sick and I missed a bit of time. I have my second surgery this Thursday the 26th at cleveland clinic. I've had pan UC for almost 10 years. Started slow only a bad flare up here and there. Then over the last 2 years it seemed like it was all one big flare up. I became dependent on steroids to stay in somewhat remission. Started remicade and it worked for about 6 months then quit. At that point I just tapped out and said I can't take it anymore. After the first surgery I've felt great which I'm sure most people do. But it's an uneasy feeling of the unknown until I get to the finish line. I did diet and all meds I could to help and they all would for a little bit, then just quit. I have never heard of the fecal transplant you guys are talking about. But I'm just patiently waiting and hoping that in a year or so I'll be able to get back out on the field and feel normal again. For me it was a chance I was willing to take. I've felt the worst that UC can offer, so Im hoping to feel the best the pouch can offer. Good luck in your decision, at some point you really do get sick and tired of being sick and tired.

I forgot to add that after my surgery the doc told my wife when he got done that it's a good thing we decided to get this done now(they moved my date up about 4 weeks). He said my colon was starting to perforate. So I guess I really didn't have a choice. I was lucky enough to get it out before it was an emergency.

I give you guys a lot of credit for even wanting to do this stuff. I can't wrap my mind around the idea of fighting for sport. But, it is popular, so what do I know? Even when I was completely healthy, contact sports did mot interest me. 

 

Looks like a good work out though!

 

Jan

I don't enjoy getting hit but there is a lot of thinking and strategy involved in boxing which I love, as well as getting you fit so it's a great sport to do