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Hi. I am not sure if I have pouchitis or something else. I get severe gripping pain in the rectal area which sometimes radiates to my stomach for a few moments until the intestine contents gurgle and move. It feel like someone suddenly shoves a stick up my butt. It is relieved by emptying pouch which is urgent. There is no blood. I have taken antibiotics for it in the past and it does go away. Is this pouchitis?? Can I make it go away without taking antibiotics ?? I also have stomach acid issues and when that flares it affects the pouch as the acid seems to travel down and lead to inflammation. Thanks for your help.
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How old is your pouch? Mine is only 3mo old but I've been experiencing similar issues the whole time. It seems like a common experience although it couldn't hurt to check with your doc. I get regular gas pain that feels like a mild version of what you described. My surgeon said it's likely narrowing somewhere in the bowel so it's uncomfortable when gas moves through there.

The last couple days I haven't been feeling so well (can't figure out if it's getting lax on my diet, pregnancy, fighting off a bug, or a combination) and the pains have definitely been much worse. Walking, getting enough sleep and getting back on track with my diet is seeming to help though.
On first read, these sound like spasms of the rectal muscle. When you are early on post takedown, these are actually pretty common and should subside over time. I had them for about the first 6-8 weeks. They could be very painful, and usually preceded a bowel movement. They came on quite suddenly. Usually they were relieved once I emptied the pouch.

However, since you are over 5 years out from your surgery, it may be worthwhile to contact your surgeon or GI to discuss this. It's possible some of this is due to your pregnancy; I'm not sure how far along you are, but scar tissue, swelling, etc, all of which can be exacerbated by pregnancy, may account for some of the discomfort you are experiencing. Of course, it could also could be pouchitis, though spasms are not necessarily typical of pouchitis symptoms. Alternatively, there may be a stricture, or you could have a spasmodic bowel (especially if this tends to happen shortly after eating). You can be prescribed antispasmodics, which may help, though it would be important to sort out what is going on first, especially since you are pregnant.'

Good luck!
Last edited by Spooky
I have been experiencing the same type of pains lately and am not sure what it is related to. I had my full take down completed in late 2009 and then I prolapsed and had to have 2 more surgeries in 2012 to repair the 1 in a million event. Now this.... calling my local GI because I'm afraid to go back to my surgeon in Chicago due to the past and him not lisenting to me. Such a tough place to be in right now.
I starting taking cipro last week and the pain went away after one pill. It's strange that the sudden sharp pain isn't typical of pouchitis and yet antibiotics works on it. I currently am waiting to get into a new gi doctor. When I finally get in I will ask if it is spasms or a stricture. I seem to get the pain along with typical pouchitis symptoms every two months (incomplete emptying, increased frequency of BMs). Have antibiotics helped stop the pain for you Victoria?
I had my takedown over five years ago. I have been dealing with that exact pain since day one. A scope showed aphthous ulcers in my pouch.doctors just gave me different courses of antibiotics which didn't do much. A Percocet once a day was the only thing that took the edge off. but it seemed like they were more concerned about the small amount pain killers than they were about making me feel better. To this day I still deal with the pain, and I no longer see a doctor. They offered me no solutions. Sometimes the pain can be controlled / aggravated through what I eat. And other times its got a mind of its own. My experience has not been a good one. Hope yours is better.
I found out through an MRI that I have inflammation in the rectal area also. I was on Cipro but wanted to come off since I don't have pouchitis. So I finally went off and around two weeks later I am having the same pain. So what do they do for inflammation? I am back on Cipro and this time I am taking it twice a day where as before I could get away with just one. The pain for me goes up my back. I have no pain meds so I just try and deal with it. I pretty much can sleep through the night, thank goodness. But during the day and the evening is terrible. I have never felt so much pain before. I told my husband it feels like steak knives going in and out. I wish someone had an answer!!! I am just two years out with my jpouch and I can't say that I have had great luck. But I am alive and just take one day at a time and I watch what I eat.
Is your inflammation inside your pouch or outside (as in: the outer walls of your pouch, but inside your pelvic cavity)?

I ask, because your pain description sure sounds a lot like my pain when I had a presacral abscess. I described my pain like a white hot poker up my butt, every time I sat down, or sat too long. I did, however, have the telltale sign of a high fever after about a month (up to 105F). Then there was no mistaking it and it showed up easily on CT. The surgeon could even feel it on rectal exam.

But early on, they could not pin it down.

Jan Smiler
Thanks for all the posts. Last time I had a scope I had been off antibiotic for 1 week and there was some inflammation lower part of pouch but it cleared up on its on. Was the abscess cleared up with antibiotics? Perhaps I should see my surgeon next time I get the pain, however that will mean I may have to endure the pain for a few weeks before I get in. Do any if you with this pain also have stomach acid issues that results in acid travelling from the stomach to pouch causing it to burn. That is what happened last time and seemed to lead to the pain/pouchitis
I just had a scope done in October and a MRI in December plus seen my surgeon and she did a rectal and said inflammation showed up on the MRI right inside my anus. So I am wondering if I have UC right there again. What are you thoughts. I have no fever. I drink only "smart water" for what it has in it for me. No pop. Just water. The pain is excruciating.

I have always had some pain and pressure there since I had my take down. But lately way worse.... No pouchitis on my MRI or scope. So I am wondering if it is Ulcerative Colitis right there.

Any other ideas? How about any medicine that would help? I did try over a year ago suppositories. OMG those hurt so bad and after a few days I had no relief Frowner
Hi Yes the pain radiates up towards my stomach and will then go away and come back again until the pouch is emptied. Last time I was on the antibiotics it went away during the antibiotics course and then returned about a week later but this time I was able to stop it. I figured out that the pain started around 2-3:30 pm during my work day but I had no pain in the morning. In the morning prior to work I take two imodiums at 7AM. When the pain returned after the antibiotics were done I took two Imodium advanced pills prior to supper (5 PM) and the pain went away and did not continue. For a while I continued to take 2 imodiums at breakfast and another two at supper. I haven't gotten into a new GI specialist yet so they have not given me further insight. I also have a lot of stomach acid which affects my pouch as the acid travels down to the pouch. Recently my family doctor increased my zantac and nexium 20 mg pills (1 morning and 1 evening) to decreases the stomach acid since then my pouch has been doing excellent. Perhaps the butt pain had to do with the stomach acid?? I don't know for sure. Do you have stomach acid issues? Perhaps the stomach acid is the cause of the butt pain.

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