Jan gave me so great thoughts on this, but I was wondering how many of you had your original Ulcerative Colitis include the anal canal (from the anal verge up)? If so, did this increase your chances of getting cuffitis? Or did the anal inflammation go away after the Jpouch surgery? I am curious about this because the anal canal is kept in tact in the Jpouch surgery. So it makes me wonder that, if the anal canal is inflamed prior to surgery and it remains in tact, what happens to it after surgery. Does the inflammation in the anal canal just go away?
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My understanding is that the vast majority of people do well with just a remainder of 1-2cm of cuff left. This is why the standard practice is to leave it intact and use a stapled technique. However, I was in the minority and developed severe cuffitis which eventually led to a pouch advancement. I always had severe inflammation in the anus with UC which extended throughout the descending colon (typical UC). I was not too surprised I ended up with cuffitis later.
vstRN - are you saying that you are not surprised you ended up with cuffitis later because your inflammation included the anus? And if it is typical UC for people to have inflammation include the anus, why don't they get cuffitis since the anus is left in tact after the surgery? That's what I am wondering about.
Sorry, not much help here. Need to correct myself and say I always had severe disease in the rectum and never had any perianal disease - always very clear cut UC and not crohns. Good luck with your decision!
Mine was clear cut UC when I had it, and I developed a perianal fistula recently. My surgeon still doesn't think I have Crohns, though, as I have NO other symptoms of it, at all. He thinks the irritation I developed from straining with my first real bout of pouchitis likely was the culprit of my fistula, though it is hard to prove. These issues can strike UC patients, though, and bowel surgery like ours also increases the risk.
UC article: http://onlinelibrary.wiley.com...d2e2bd567974453e3c5e
UC article: http://onlinelibrary.wiley.com...d2e2bd567974453e3c5e