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Hi everyone

I am a newbie to the forum and I'm so glad I have found it as I don't know anyone else with a pouch and I have felt quite alone with this for the past 19 years.

A bit about me: I had my colectomy, followed by J pouch creation, then reversal of ileostomy, beginning in 1997.  I developed an abscess at the anal anastomosis almost immediately, however my team would not listen to me and the result was septicaemia, an excision through my buttock, an unplanned second ileostomy to allow healing, and another reversal.  

I was pretty well for many years until I began to have problems with adhesions & strictures, resulting in episodes of total obstruction, faecal vomiting and trips to A&E (ER - I'm in UK). I've had several surgeries to remove adhesions.  I'm currently waiting for another dilatation, however I have already waited 18 months to see my surgeon on the national health service so I am having to go private, which will cost me £2500.

To my curious (and embarrassing) question!  Every since I've had my pouch, I have been unable to pass gas in an upright position.  The only way my pouch will allow me to pass gas is if I am lying face down with my forearm beneath me to create some pressure, and a lot of wriggling.  No-one seems to know why this is or how to correct it....it is just positional with my pouch.  As you can imagine, this makes travelling, working in an office and being in other people's houses quite difficult, and I am often in pain because my environment is not conducive to my 'antics' and I have a lot of painful cramping due to trapped gas. Also, when I finally do get a chance to do my thing, it is quite explosive as it has sometimes built up over the whole day.  It also makes my belly ridiculously noisy.

This has really affected my confidence.  My initial reaction to any invitation to go somewhere is 'what is the bathroom like and how will I cope in that situation'.  I am 47 and was widowed 6 years ago....I'm really struggling with a brand new relationship because I am embarrassed and ashamed.  I cannot share this gas problem as I do not want my partner to have a visual in his mind of me doing this.  I need a lot of privacy.  I cannot even visit his home because he has a minuscule WC, which is separate from the bathroom, whereas I need space to move around and stretch and lie on a towel on the floor in between sitting on the loo.  He does know all about my surgery and all the other various associated bathroom/dietary problems.  However, what should be a wonderful invitation to spend a romantic weekend in New York, for me is a terrifying panic of 'how on earth can I share a hotel room with this man'.  I'm a ball of fear of being trapped in an embarrassing situation.

Does anyone else have this particular positional problem with gas?

Replies sorted oldest to newest

Maybe (likely) it is a structural/positional thing. But, something I have noticed is that when I have active pouchitis, I also have a crazy amount of painful gas. Plus, it can seem to be trapped and difficult to pass. Antibiotics completely turn this around, with a huge reduction in gas and easy to pass at the end of a bowel movement.

You may have better luck seeing a gastroenterologist instead of a surgeon. 18 months seems like an intolerable wait. If this is not a surgical problem I see no point in waiting to see a surgeon. Of course, if you've seen the GI and are waiting for the surgical consult, that is different. I have not seen my surgeon in 19 years.

SJan

Jan Dollar
Last edited by Jan Dollar

If only I had some idea long ago before the internet even existed and I received my pouch that gas would be this bad of a problem I would have said "no" to j pouch surgery and take my chances with my colon.   So far gas has been a no win situation for me.   I can control it a little by what I eat, but getting it all just right is like walking through a minefield.  The problem is now that you have so little storage space, the gas that once had plenty of space to co exist in you has little to nothing and is screaming to get out.   I don't know what to tell you.  Ileostomy is the only alternative.   All the over the counter no gas stuff wasn't designed for pouches. 

FM

Thanks for your replies. Scott...the problem is completely positional...I can't pass any gas at all unless I lie flat on my stomach. Which means switching from loo to floor several times during a visit to the bathroom. This has been the case from the beginning with my pouch. It's a royal pain in the ass!

Jan...the wait is for dilatation of strictures..this is why I've decided to pay to have it done privately now. 

What do you all think of probiotics for pouch maintenance and gas management?

Clarice

When the most prominent problem is gas, the issue is frequently bacterial overgrowth. The treatment is 2-3 months of antibiotic (e.g. Doxycycline). I don't think probiotics will usually help much.

This applies to *excessive* gas. Clarice, if you can't pass any gas on the toilet you might have a structural problem, though I'm not sure what would cause that. 

Scott F

I guess it all depends. I'm sure my doctor has to prescribe it with exception codes to get it for the standard brand name copay ($30). Plus, I have to pick it up in person (no mail order) and can get only a 30 day supply at a time. 

You can also use Flagyl, Cipro or other antibiotics to reduce bacterial overgrowth. But, they are more likely to cause side effects. Still, I'd rather use them from time to time than deal with intolerable gas. 

Over the counter gas products do not prevent gas (other than Beano and similar, which help digest carbs). Most intestinal gas is from bacterial action on undigested carbs.

Jan

Jan Dollar

Clarice I am exactly the same. 

I don't have chronic gas but when I do get gas I am unable to release it. I have to lay on my back with my legs in the air.

I'm unable to release it sitting on the toilet also. It does make socialising more difficult going out with friends etc.

At work the majority of my colleagues know about my condition, I work outside alot and they know if I'm on my back not to come and help I'm perfectly fine lol. It was embarrassing at first but then I thought bugger it if I need to pass gas I will I'm not having a painful bloated stomach all day.

It's been the same ever since my J pouch and I've just learned to live it nothing I've tried has helped including diets etc. 

Good luck

Chris1985
Last edited by Chris1985

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