Rohit, bleeding is often a sign of cuffitis, which is like ulcerative colitis in the remaining bit of rectal cuff that your pouch is attached to. If the antibiotics aren’t really doing the job then mesalamine administered rectally may help, either as an enema or Canasa suppositories. Good luck!

Thanks scott for your reply.

But i am thinking that is it possible to have such huge amount of bleeding from the cuffitis because i checked for hemoglobin and it has dropped from when i started bleeding

It can be a case of cuffitis as mentioned by scott or even a fissure . My surgeon adviced me not to try to hard to get things out of the pouch. Its not like a real rectum. If there's a pain in your abdomen it could be cuffitis if only the bottom part pains you may just have fissure. Try switching to a soft diet for a few days and see what is cause or recurring blood. You can keep going on higher doses of meds but thats not a long term solution . Try finding out the root cause. Also I drink wheatgrass juice to keep my Hb levels steady . You can give that a try too.

I managed to stop heavy bleeding by eliminating sugar. Diet and fasting can really help to maintain a healthy pouch.

Thanks drone 3 i will really try it

It’s pretty important to identify a cause of bleeding. A pouchoscopy might help a lot. 

Hello Rohit. Has the bleeding stopped? Did you discover a cause? Give us an update if you can. Thanks.

It is bleeding but a small amount

I have dealt with bleeding myself.i had my j pouch created in 2009 and started bleeding that caused my hemoglobin to drop so much I hve had 11 blood transfusions within a year. Have had Endoclips places and cautery with no results started Entyvio tappering prednisone started lialda again fingers crossed 

Not always the bleeding is because of cuffitis, because some surgeons decide to remove every inch of rectal cuff and the last 1 cm to remove the mucosa (mucosectomy); so that there are just some remaining cells of rectum. This is my case, my surgeon always told me that I have no more inches of colon/rectum now. Probably that's the same case of the fellow who opened the thread, I think it because his doctor prescribed always antibiotics, which is the treatment for pouchitis. The bleeding in pouchitis is not a symptom which happens always, but can happen . 

I've been having bleeding as well, but just on the toilet paper. It showed up with a tiny amount and last night there was quite a bit. My  bottom is literally throbbing and very uncomfortable. Does this sound like cuffitis??

It sounds more like hemorrhoids to me, Mema.

Thanks, Scott, I really appreciate your come back. What do I do about them??? I get really frightened when I see all that blood on the toilet paper.

Could you possibly have a fissure? Fissures can cause bleeding and throbbing pain when your having difficulties empty your pouch or feel the need to strain usually they prescribe nephedipine ointment which helps with fissures but also helps to relax the spasms in the rectal area

Thanks Pink Lady, and that's what I'm doing, straining. I think that it's possible that I have a fissure and/or hemorrhoids. I'm guessing that the ointment is not OTC .... will have to contact my doctor and see if he can prescribe it. 

I have experienced the same issue.ita not over the counter it’s a compound that the pharmacy has to make.You use before and after every bowel movements sits baths also help to relax the Sphincter to help with those symptoms 

It would be best to visit the doctor to properly distinguish between hemorrhoids and a fissure. The straining is quite harmful in either case. Soluble fiber could help soften the stool and potentially reduce straining. *Anything* that stops the straining will be beneficial.