I have developed fistulas and have an abscess near the rectum in the j-pouch (which has worked pretty well for 8 years). My surgeon now tells me that I probably have Crohns and says my pouch must be removed and get a permanent ileostomy. He is fine with me getting a second opinion but I understand that the popular doctors like Remzi are no longer at Cleveland Clinic. Anyone have recent experience there? Also since I apparently have Crohns, are there options besides j-pouch removal?
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Do you have a gastroenterologist? Crohn’s sometimes responds well to biologics, with Remicade offering the most success experience. Surgeons will often focus on surgical solutions.
Remicade isn’t likely to clear up an abscess by itself, though.
Yeah. I’d get a second opinion from a gastroenterologist. You may need medical management whether yout pouch is removed or not. Biologics may heal fistulas from Crohn’s. Dr. Shen is still there at the pouchitis clinic, right? He should be able to tell you if your pouch is salvagable.
Jan
Jan, I'm waiting to hear about a consult with a colorectal surgeon at CC. It would be great to consult with Dr. Shen too, but I'm not sure it can be arranged. It's at least 5 1/2 hour drive for me, so I don't want to make multiple trips especially this time of year.
Of course Dr Shen is still there.. When they had the mass exodus of a lot of surgeons leaving last summer I asked him if he was going to leave and he told me, "Nobody else wants me". lol. love this guy
I hope that I can see Dr. Shen, but I don't think he does surgery. Is there a surgeon at CC who you would recommend?
Shen does endoscopic procedures that not a lot of other GI's will do, but correct he is not a surgeon. I honestly cant recommend a surgeon so many of the good ones have left. I know Dr Remzi speaks highly of Dr Dietz who left clinic and went to University Hospitals in Cleveland which is actually right down the road from Cleveland Clinic