Had a scope by my GI last week, pre-takedown due to nausea, bloating, heartburn, and feeling "swollen" near the rectum. GI said pouch looked good except that it had some inflammation at the bottom. She said she thought this was due to my digital exam by my surgeon two days earlier. Do you think this is possible or are we missing pouchitis? Just started having some on and off mild abdominal cramping the last 2 days since scope as well. Is inflammation a definitive marker for pouchitis? Thanks.
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Well, pouchitis just means "inflammation of the pouch," but that's not really your question, I think. The key question is probably something like "should I take antibiotics for this?" If your symptoms started shortly after the scope, and you felt fine beforehand, I might give it a week or more to see if things calm down on their own.
Thanks for your reply, Scott. Actually, my symptoms started two weeks prior to the scope, which is why they did the scope. Two days prior to the scope, my surgeon did a digital exam. My GI doc is actually the one that did my scope. When she saw the inflammation, she said that it was probably just due to my digital exam two days earlier from my surgeon. However, I had had symptoms for 2 weeks already. The only thing to start as a new symptom since the scope has been the abdominal cramping. So, I guess I am trying to figure out if I need to be treated for pouchitis or if inflammation can be caused by a digital exam? My gut tells me that it is more than the exam since the symptoms started earlier... I would like to figure this out before my takedown, because if I already have pouchitis without being hooked up, that makes me worried I will have it more later. Thoughts?
Unless that exam was particularly vigorous, I doubt it would cause notable inflammation. Just because it is in the lower end of the pouch, that is not an indicator either. The fact that your symptoms are escalating also might point to pouchitis. But, still, the trauma of exams and scopes can cause pouchitis like symptoms.
My last bout of serious pouchitis was right next to the rectal cuff, and I had not had any prior exam. Maybe your GI was just thinking/hoping out loud. Bottom line, if it does not resolve in a few days, then it is regular pouchitis.
Jan 
Jan,
Can nausea, bloating, and indigestion/heartburn be symptoms of pouchitis? Most morning I just wake up nauseous and eat just because I don't want the output from my ileostomy to be complete water. Gotta eat for it to be thicker and not cause problems under the wafer. Otherwise, I don't even care to eat right now most of the time.
Can nausea, bloating, and indigestion/heartburn be symptoms of pouchitis? Most morning I just wake up nauseous and eat just because I don't want the output from my ileostomy to be complete water. Gotta eat for it to be thicker and not cause problems under the wafer. Otherwise, I don't even care to eat right now most of the time.
Generally, I'd say no. Those are upper GI symptoms. But, untreated pouchitis may cause widespread symptoms. My last bout with it caused pretty severe upper abdominal pain, but no nausea. Some loss of appetite though. But, I never get nauseated. I am nearly 60 and can count on one hand the times I have been nauseated, so I probably am not a good comparison. My point is that is you have known pouchitis, treat it and see if the other symptoms resolve. If not, then there is something additional going on. It is not impossible to have simultneous issues (it has happened to me).
Jan