Advice? and Questions, Pouchitis? Tooth Infections? Antibiotics etc.

hey, I had a pouch redo with mucousectomy back in October, and takedown 4 weeks ago. The whole time after my redo up until takedown, I had annoying mucous discharge several times a day. Sometimes I could feel it coming and sometimes I could not. It ranged from clear to yellow to brownish in color. I was so very worried I would be leaking stool after my takedown that I was obsessing about it. 4 weeks after takedown I have very little leakage. It is very minimal to be honest. I think I am starting to deal with pouchitis now though?? No urgency, but stomach is very crampy and I just don't feel that great. A lot of people are ill lately so not sure if its just that or beginnings of pouchitis?

That is a lot of broad spectrum antibiotic. Still, it does not sound like things are messed up. Maybe you are just getting some stool. Bypassing the stoma, hence the color change. If you really had a total mucosectomy, there should not be any cuff bleeding. If the oral infection is taken care of, you should not be on amoxacillin.

I suppose it is possible that you developed a C. difficile infection with all those antibiotics that all C. diff strains are resistant to. But, I would expect you to be more symptomatic. If you are concerned, perhaps it is time for a test to rule it out.

Another consideration is a possibility of diversion pouchitis. The cure for that is take-down of the ileostomy.

Jan

What is the test for c-diff and what are the symptoms? 
Little update- I was put and another course of amoxicillin that ended 4/1/16
Didn't help a whole lot. And now my butt is sore inside the cuff I'd say.
and I'm seeing bloody mess discharge when I sit on the toilet. I don't know what to make of it. It's been making me annoyed and uncomfortable for at least two months now. Side note-been dealing with high stress with a ill elderly mom. I know that plays into it for me too. Doesn't help that's for sure.

Ideas?

Thanks
Alan

C diff is generally tested for in a stool sample, best if you haven't been on antibiotics for a couple of weeks. The PCR test is more sensitive than the less expensive test.

I would suspect diversion pouchitis as well.  I had it and Shen got it to stop after a scope with one of his tricks. When I had my scope a few weeks ago with Shen, I asked him since I had a handsewn mucousectomy if I technically did not have a cuff any longer, and he kind of smiled and said I do have a cuff sort of... where the intestine is sewed into the sphincter the connection site can still be considered a cuff per say. interesting

Yeah, there is always a little "something" left behind, otherwise there isn't much of anything to sew to. Plus, with the mucosectomy, it is pretty difficult to get every single cell and patch of mucosal tissue out. 

Jan

So what is Diversion Pouchitis? and is there a real definition of pouchitis?