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Hi All,

Sorry for the incessant questions and concerns. This has been a rough period. Just saw my surgeon yesterday for 3 week post-op visit and I explained all the issues I’ve been having (detailed in several of my other posts so won’t belabor the issue). He did a DRE (ouch) and told me he could get the tip if his finger into the anal anastomosis. Said maybe it was a bit narrow but did not think it was preventing stool passage and did not suggest a dilation at that time. He is more concerned about ruling out an abscess (I’ve have had a complicated course) as the cause of my symptoms. CT today.
I have a lot of issues with incomplete emptying, fullness, straining and I’m wondering if this “narrow”‘outlet is contributing and I need to request that he dilates the stricture?

What is the normal or target diameter of the pouch opening? Tip of a finger sounds small to me.

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Jan DollarJan DollarModerator, RN, retired

I have never had a digital exam where the doc could not fully pass a finger beyond the sphincters. So, unless your doc has big sausage fingers, you are constricted. Still, I think your doctor is correct that you should be able to pass stool that is not too thick. I would stay away from roughage, no fiber supplements, and make sure to keep your fluids up. I hope it is not an abscess. Good luck with the CT.

Jan

Jan Dollar
P Pouch2021Member

Thanks all. My surgeon has pretty slender hands so it seemed small to me. Hate the idea of needing to further restrict my diet rather than expanding it which is what I thought I would be doing. But eating fruits/veg would make me nervous right now. CT showed a persistent presacral collection, not walled off or rim enhancing so not sure what my surgeon will say. I just wish I didn’t have all these variables (prior abscesses, tons of obstructions) to think about in addition to the immediate pouch  issues. Makes it hard to sort out what’s causing what. Stressful.

P
Jan DollarJan DollarModerator, RN, retired

Yeesh! So much to sort out and still having to wait and see what is next. But, unfortunately we just don’t get to choose our outcomes. At least you have somewhere to go and gripe where people know what you are dealing with. We can’t make things turn around for you, but we understand.

Be the squeaky wheel until you get your answers!

Jan

Jan Dollar
FM Former Member
@Pouch2021 posted:

Thanks all. My surgeon has pretty slender hands so it seemed small to me. Hate the idea of needing to further restrict my diet rather than expanding it which is what I thought I would be doing. But eating fruits/veg would make me nervous right now. CT showed a persistent presacral collection, not walled off or rim enhancing so not sure what my surgeon will say. I just wish I didn’t have all these variables (prior abscesses, tons of obstructions) to think about in addition to the immediate pouch  issues. Makes it hard to sort out what’s causing what. Stressful.

Your welcome

FM

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