You are probably due a pouchoscopy anyway.  It's the same thing as a flex sig with our pouches.  I'm guessing your insurance would pay for it if it pays for colonoscopies. I've had small bowel studies that might be a good test too.  You drink barium, use a straw, and they take x-rays every so many minutes to capture how your small intestines are looking.  At the end it also shows up in the pouch. The barium water looks white, like bones do, in the x-rays and they can see if there are kinks, strictures or other problems up stream from your j-pouch.

My local GI said anyone in his firm could do the scopes but I live in a larger community. He performed the first scope I had and caught cuffitis and c.diff from it.  I hope you are feeling better soon.

I would get in to see a local GI based on your symptoms for at least a consult. You need follow up for your FAP anyway, so see if you can find someone who deals with that. I think the FAP knowledge is more important that the j-pouch knowledge IMO. For a scope, they usually schedule it as a sigmoidoscopy, but you don't need the big prep. My GI uses a pediatric endoscopy scope, not a sigmoidoscope, because it is more maneuverable than the thicker sigmoidoscope.

If you have these periodic partial obstructions, it is not likely due to what you eat, than due to narrowing from adhesions from your surgeries. As your gut moves around, the adhesions can cause kinking, making it more difficult for roughage to pass. Since you have more lingering symptoms this time, you need some follow up. Some simple x-rays can rule out anything major. Anyway, all the more reason to get the GI consult so that he can figure out how to sort this out.

Good luck, and I hope you feel better soon!

Jan

Thanks for the quick responses. I'm feeling a little better today, but I will definitely try to call tomorrow morning and set up a flex sig with a GI to get a better idea of what is going on. 

You can't really get a "flex sig," because you don't have a sigmoid colon any more. You can get a pouchoscopy, though. Some doctors might use a flexible sigmoidoscope to do it. As Jan mentioned, even that is unlikely, since a pediatric endoscope is better suited to explore a J-pouch. They might bill it as a flex sig, and they might casually (carelessly?) tell you to use the same prep as a flex sig.

How much better is it for the GI to use a pediatric endoscopy scope vs. a flex sig scope? From what I can tell, it looks like they'd do the pouchoscopy with the flex sig scope since they don't deal with pediatric patients at the same place. I'm still waiting to hear back from the local doctor if he's willing/able to do a pouchoscopy and/or has any experience with FAP and jpouches, but would it be a better idea to try to go to a major city? I work for an airline, so I can fly to Dallas within the hour at no cost. Should I try to find a GI there who has more specialized experience with FAP and jpouches?

A pouchoscopy can definitely help rule out pouch issues and narrowing right above the pouch, but diagnosing a blockage, especially the cause of a blockage, is tricky.  CTs or abdominal MRIs can give a pretty good idea of what is going on (when you're having an actual problem), but residual pain/discomfort can last for awhile so sometimes nothing will show up.  For me personally, I have dealt with many obstructions, but until I was opened up for surgery to find all of the adhesion bands causing the issues, the doctors couldn't rule out inflammation and strictures from Crohn's.  You can have upper and lower scopes done to help create the bigger picture of what is going on, but again, those can be misleading if everything has been aggravated from an obstruction that was there that has passed.  

To your immediate question though...yes, symptoms can last for a long time afterward and to Jan's point, there could be an issue that hasn't fully cleared up.  Multiple times I have been in the hospital for obstructions, gone home for a couple weeks, then ended up right back there again.

Hope you get it figured out!

Also to add...CTs and MRIs require oral contrast to get really good images.  During an obstruction when you can't keep liquids down or to pass, that's obviously not an option.  If you are able to keep liquids down, a CT or an abdominal MRI (MRE), could provide a really good picture.

I have to ask yellafella37, how do you know that you are having a blockage or have had a few of them since your surgery since you have rarely been back to a doctor? I am just wondering exactly what your symptoms are. I am wondering if perhaps I might be having blockages occur but don't know. The pain and bloating starts shortly after eating and then the bloating becomes extremely localized to the area where my stoma was. It is almost as if I have a golf ball inside of me moving around up and down. I have wondered if it is just gas or a blockage of food, my stomach just moves up and down and the pain continues until the bloating goes down sometimes with a bowel movement or it just seems to gradually lessen and go away. My body has been known to make a lot of scar tissue and just recently it has occurred to me that there could be scar tissue there as that is where the bowel was re-connected during takedown. My colectomy was one year ago and my takedown last November and my body is just not adjusting to this at all. I have lost all the weight I gained during the time I had a PICC line in during my last surgery and I cannot identify any foods as good foods that I digest well. I have had a pouchoscopy and no pouchitis. The way I am visualizing this is that there is no way a pouchoscopy can show you what is going on that far up, near the stoma. As someone suggested I am guessing it would have to be a CT or MRI. I did have the barium test after the colectomy but before the takedown; drinking the barium and the pictures being taken every 15 minutes or so. All was good then to proceed with the takedown. I am seeing my GI dr next Tuesday and will bring up my symptoms to him. Hoping he has some thoughts on this to get it figured out. I am not sure anything can be done about scar tissue as usually more surgery results in more scar tissue. Has anyone dealt with scar tissue?