I had a LOT of anal/pelvic pain post op. But, within a month I developed a 105 fever and extremely intense rectal pain, which was determined to be a large pelvic abscess. It was due to a pouch leak. The leak sealed on its own, but the abscess put me in the hospital for 12 days. I did completely heal from that fiasco.

I would think that if you had something like me, you would know by now. But, sometimes these sinus tracts are insidious. Since you do have emptying issues, it makes sense to assume that it likely is something that can be helped with pelvic PT.

Jan

Hi Pouch21,

I am sorry that you are suffering so badly.  The sinus problem seems to be a real challenge when they present.  As far as the constipation - I seem to have that intermittently also whenever I eat fiber.  More than I would care for. I had my reconnection surgery May 6th - so I am two months out.  To be honest I am getting worried about how much I have to strain.  In your case, how does the dilation get performed- under sedation?  How does the CRC determine if you need or warrant dilation.  I feel like I may need it, but don’t want to do it unless it is deemed necessary - how can you tell?  I have little idea what is normal here.  As for your question about straining - I hope that after a few mor months that goes a away for you.  It seems like it does for many patients.

I've been doing pelvic floor therapy and it's helped me a lot. Strengthening muscles, learning some breathing techniques.

WOuld not recommend straining, that can cause J-pouch prolapse and bladder prolapse. I have had anal/pelvic pain after going but its only sometimes if I did not drink enough water. Maybe you need more water? And I would definitely recommend using diaper rash cream like Calmoseptine.

@Doug K posted:

Hi Pouch21,

I am sorry that you are suffering so badly.  The sinus problem seems to be a real challenge when they present.  As far as the constipation - I seem to have that intermittently also whenever I eat fiber.  More than I would care for. I had my reconnection surgery May 6th - so I am two months out.  To be honest I am getting worried about how much I have to strain.  In your case, how does the dilation get performed- under sedation?  How does the CRC determine if you need or warrant dilation.  I feel like I may need it, but don’t want to do it unless it is deemed necessary - how can you tell?  I have little idea what is normal here.  As for your question about straining - I hope that after a few mor months that goes a away for you.  It seems like it does for many patients.

Thanks for the replies. I’ve had pelvic abscesses in the past and I don’t think that’s the case here. I agree, would expect to feel more systemically ill as before. This is more of a persistent ache in my sacrum and coccyx as well as very low pelvis, which seems to be exacerbated by BMs. It’s actually present even if I don’t strain all that much.

Doug, my dilation was performed in the OR under propofol. Didn’t feel anything during or after. Was no big deal. My CRS determined it was strictured by DRE. I just saw him again for the pain, straining, difficulty emptying and he didn’t find I was that tight on DRE. He estimated 13 or 14 mm which should be fine for function. He dilated me to 19 a few weeks prior so it’s closed a bit but not enough to do it again.

Just wishing this anal soreness, pelvic cramping and aching tailbone would get better. Oh, and the newish epigastric cramping which I’m assuming is gas. Ugh. I can only hope it’s par for the course of healing but I’m not sure. Still not in love with my pouch.

So what is the next step for you?  I hope you feel better soon.

@Pouch2021 posted:

Thanks for the replies. I’ve had pelvic abscesses in the past and I don’t think that’s the case here. I agree, would expect to feel more systemically ill as before. This is more of a persistent ache in my sacrum and coccyx as well as very low pelvis, which seems to be exacerbated by BMs. It’s actually present even if I don’t strain all that much.

Doug, my dilation was performed in the OR under propofol. Didn’t feel anything during or after. Was no big deal. My CRS determined it was strictured by DRE. I just saw him again for the pain, straining, difficulty emptying and he didn’t find I was that tight on DRE. He estimated 13 or 14 mm which should be fine for function. He dilated me to 19 a few weeks prior so it’s closed a bit but not enough to do it again.

Just wishing this anal soreness, pelvic cramping and aching tailbone would get better. Oh, and the newish epigastric cramping which I’m assuming is gas. Ugh. I can only hope it’s par for the course of healing but I’m not sure. Still not in love with my pouch.

Your welcome, wishing you nothing but the best

Next steps are PT and a trip to NYP to see Bo Shen about the sinus tract. Who knows. I’ve experienced way worse pain than this but I’m just tired of the persistent discomfort. It wears on me and makes a long day at work that much tougher.

@Pouch2021 posted:

Next steps are PT and a trip to NYP to see Bo Shen about the sinus tract. Who knows. I’ve experienced way worse pain than this but I’m just tired of the persistent discomfort. It wears on me and makes a long day at work that much tougher.

Okay keep us updated, hope things get better. I will keep you in my prayers.