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Hi all,

This is the first time I have posted. Had colon removed 2007 due to uc, takedown 2008. I must say that you all seem so much more informed than I am. I have learned a great deal just from reading your posts. I have been dealing with pouchitis off and on since the take down and the last 6 months or so seem to be getting much worse. I guess my question is: Is a Flex Sig the same as a Pouchoscopy? Last week when I was reading posts is the first time I've heard of a Pouchoscopy also have never heard of Cuffitis, Stricture or Fistula. Last time I had a scope (flex sig) my G.I. asked me why I was doing this? I told him, my surgeon said that every three years they needed to take a look at my pouch and that I was having increasing bouts of Pouchitis and trying to get a handle on things. He said, why don't you just go back to your bag?..... I changed G.I. docs and I have an appointment next week and hope to talk about going on a "maintenance" anti-biotic. I just finished a round of Flaygl after 2 rounds of Cipro didn't do anything and am doing better but feel like the Pouchitis is trying to creep back in. Symtoms include lots of gas build-up no matter what I eat, more urgency, lots of stomach noise and of course the constant pain and discomfort, extremely weak and tired. Anyway, thank you all for posting, it does help to know there are other people out there who have been through this. Take care everybody.
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The last part of the colon before the rectum is called the "sigmoid colon." When they use a scope to look at the sigmoid colon, it's with an instrument called a "flexible sigmoidoscope" (or "flex sig"). This is basically just a short version of a colonoscope. J-pouchers don't have a sigmoid colon, so when we have a pouchoscopy (viewing the J-pouch through a scope) it's done using a flexible sigmoidoscope. To make it even more confusing, the procedure codes that docs use often lack a specific code for pouchoscopy, so they sometimes do the best they can by coding the procedure as a flexible sigmoidoscopy.

Hopefully your doc will try to distinguish between antibiotic-dependent pouchitis and SIBO (small intestinal bacterial overgrowth). The treatments are similar, so I wouldn't get too worried about which it is. It's sometimes both.
Thanks for the reply Scott, that did clear things up for me, I just need to make sure that they are going into the pouch to look, which I think he did since he mentioned that he found some inflammation.

I think I'm going to see if the Doc will set me up with orders of flaygl and augmentin since the cipro doesn't seem to do much anymore and just try to rotate when I have a flare up, hoping not to be on them daily. I think you may be right about the SIBO since I have the huge gas buildup, I thought I read in one of the posts that bacterial growth can cause excessive gas. Thanks again,

Pj

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