Apparently I've had ulcers in my pouch most of its life (about 23 yrs) - I've went back and reviewed all biopsies throughout the years. There have been some in the ATZ from time-to-time as well. My latest scope notes the pouch ulcers are superficial, mid-pouch, geographic.
Honestly, I don't know if they cause problems or not, as I have no real pain inside, no bleeding. However, I do have pouchitis 2-3 times/yr. which respond to antibiotics, chronic cuffitis which is treated with Canasa and Anusol, RV fistula with seton, at the dentate line (no ulcers at the interior fistula opening) - and a recent, "official" Crohn's dx.
If there seems to be no pain or problems with the actual ulcers (???) how important is it to "treat" them? I understand this is a strange question after having had ulcers this long - but none of my docs - including Shen and my CC surgeon - seemed to ever make a big deal out of them, so neither did I. I know, the old "head-in-the-sand" approach.... But I'm seeing my new-ish GI guy next week, and would like to be prepared to discuss this with him.
Yeah, I am still considering pouch removal - mostly due to fistula - but in the meanwhile - and just in case I decide to hold on to it for a while longer - I'm wondering if there's any need to try to act on the pouch ulcers now, or continue as is.