Acute Pouchitis - Is Treatment Needed?

This doesn’t sound like pouchitis to me, or even pouch-related, though almost anything is possible. Is the pain near your old stoma site (if you had one)? Depending on the location a kidney stone, a partial obstruction, and a hernia are among the things that come to mind as possibilities.

Thanks for the reply Scott.

It's not really pain maybe the slightest bit of discomfort.  But yes the feeling persists in the general area of where my stoma used to be.  I feel it maybe 1-2 inches above my previous stoma.  The feeling persists about belly button level, about 1-2 inches to the right of my belly button and stretches to my right side.

So along with the very slight cramping feeling and the increased level of stomach "gassy" noises i don't have any other symptoms.  I'm not overly concerned but now this feeling has stretched into over a week, figured i'd get the community's thoughts.

And whether or not it's pouchitis - just in general do you know if acute pouchitis will go away on it's own w/out antibiotics?  I probably should know since i've had the pouch for 20+ years now, but like i said i've really had no issues with it in the past to even contemplate - and everything online talks about it being treated via antibiotics 

I kind of agree with Scott that if it were pouchitis you would notice an increase in frequency and nighttime leakage issues. It's likely not pouchitis.

Acute pouchitis if left untreated will get worse and will get increasingly symptomatic. It's highly unlikely to go away on its own. Furthermore Cleveland Clinic studies (run by one of my former GI docs) have shown that in the very few ileal pouch cancers that developed, most of them were a result of severe refractory pouchitis. In other words pouchitis that became severe because it was lightly treated or left completely untreated on the notion that it would go away on its own. Those patients ended up losing their pouches.

Thank you for the insights.  I may see if it subsides in the coming weeks, if not schedule something with the doctor. 

If it is a partial obstruction at the old stoma site you could try a laxative or some days with fluids only (no solid food).

If you do try a laxative (I’d try a fluid diet first) then MiraLax is the usual one suggested for J-pouchers.