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I have 3 strictures....2 in terminal ileum and 1 30 cm above my pouch. All found in a pouchscopy. The one that is 30 cm above my pouch is suspected to be due to scar tissue, possibly, from the loop ilestomy. I have had partial blockages my gi doctor and, now, surgeon, feel a barium enema would allow them to know which stricture is the problem (even though the doctor that did the recent pouchscopy) notated that he feels the one  from my ilestomy is the trouble maker.

So, i went to get the test done, cleveland clinic but not main campus, and the doctor to do the barium enema said he wouldn't do the test....he said enough tests had been done and wasn't worth the risk. I just had a call with the surgeon and she insists they need to do the test but she is pretty "new", which makes me nervous.

So, i have had 4 pouchscopies in the past 6 months.......routine one, 2 to dialate the 2 stricutures in my terminal ilieum (august 2024 and oct 2024) and then the one 2 weeks ago that found the 3rd stricture. And, I have had 2 cat scans....most recent one was 3 weeks ago.

I don't want this barium enema and everything i have read says not "preferred" test anymore.

Any opinion on this? I am so sketchy with doctors. I asked the surgeon was the alternate test to the barium enema and she said a drinking test that takes 6 hrs.

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It is unclear to me what more would be gained from a barium enema that was not viewed on a CT scan with double contrast. Barium enema is done under flouroscopy, so more radiation than a single film. There is also a rare risk of perforation. I would be inclined to wait and let the radiologist and surgeon “duke it out” and settle on what is in your best interests. You certainly do not want unnecessary risk exposure for minimal benefit. But, if the surgeon can convince the radiologist of the medical need, then it would make sense.

I see no harm in waiting it out.

Jan

Thx for responding. I hoped u would respond bc I was sure u heard of it. The surgeon is sticking with needing it....she said it would better identify where the problem is, although I've had ct scan and I've had a pouchscopy  wks ago. It's cleveland clinic but a newer surgeon, although appears to be well accredited, as appointed there in 2023 and came from Ukraine. Im thinking about 2nd opinion, although i feel bad doing that. She is talking about...depending on how much bowel is bad, I could lose my pouch (although she said unlikely).  She as recommended by my gi doctor, who is also newer. I had my jpouch done there 17 yrs ago hy a very experienced surgeon....i know we ALL want experience but seems difficult to get anyone with experience.  Woukd u do a 2nd opinion, which is challenging their decision?

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