I have had my jpouch since June 2010. I had absolutely no problems until November this past year. I now am facing bleeding in the stool and when I wipe, urgency to go, and many other similar symptoms to the UC I had. My GI has had me on high dose of steroids which helped, but upon tapering down, my symptoms continue to come back. It seems when I so much as have a bite of anything with a dairy product in it (milk, butter, etc), it worsens the symptoms. I have eliminated dairy all together, but can't seem to get back on track. I am still on steroids, taking my pro biotic, and eating a good diet. I was wondering if anyone has encountered this continuing issue with the bleeding?
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The blood makes this sound like cuffitis, which is like ulcerative colitis in the 1-2 centimeters of rectal tissue left behind to attach the J-pouch to. Oral steroids might have been worth a try to get the flare to stop, but you don't really want to be on them long-term if you can avoid it. Conventional UC meds, especially administered rectally, are your best bet for managing cuffitis. If it can't be managed medically, a surgical option is pouch advancement with mucosectomy.
Since this seems like more than a minor flare (I agree that it sounds like cuffitis), you probably need to be scoped to confirm what is going on. Oral high dose steroids are not usually a first line treatment for cuffitis. Topical mesalamine or hydrocortisone is more typical. I would ask about going on one of them before tapering the prednisone, so it is working before the withdrawal.
Jan 