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I posted this message on the pouchitis discussion group as well. I had a one step j-pouch done in June, 2007. From the get go there have been problems with chronic pouchitis. I've tried several different combinations of antibiotics for long periods of time. The pouchitis seems to be antibiotic resistant. Nothing else I've tried has helped. I'm about 15 pounds under weight and despite eating well and frequently, cannot gain weight. I also suffer from chronic sleep deprivation as I'm up several times a night going to the bathroom. I need to empty my pouch 10 to 15 times a day and have constant partial incontinence (leaking) causing me to need to wear pads all the time.
I do not have pain which is a blessing but often feel a general unwellness: fatigue, low energy, bloating, pressure, etc. I've had tests and it seems that the pouch is functioning properly, ie emptying completely.

I'm considering having the j-pouch removed and going for a permanent ileostomy. This would be a last resort. It can't be good for my general well being to live indefinitely with chronic inflammation. My GI has suggested trying Remicaid but I have not heard of anyone with pouchitis who has had positive results using this drug, have you?

My desire is to reach a place of optimum health and quality of life for myself. Any feedback around this huge dilemma would be much appreciated.
Rhema
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Hi Rhema

Sounds like you're having a real bad time. The short answer is, only you can decide what is best for you. I waited really for 5 years before I went ahead & got the stoma. I was having blockages around two a year and very painful cramps, vomiting and not eating for days on end. I went from 9 stone to 7 & half stone (at the end) & had no choice when I was admitted to hospital. I was put on a line direct to my stomach to build up my strength for the op (for 4 weeks). They left the pouch inside me as it would have caused more problems taking it out.

My advice is all about quality of life. Do you really want to continue to wait for things to improve (which I guess they could) or go for the operation. Having a stoma is a compromise, but so was a pouch. I only have to change the bag every three to four days, so it's not the end of the world. There's hardly any discomfort and no smells or leakages at all.

Good luck in the future and I'm sure others will add their views. (Hope I've helped a little bit?)
Hi Rhema,

I had a j pouch for about 3 years, and had some of the same issues you did. I tried every combo of antibiotics, and other meds, including injections of Cimzia. Finally my pouch gave out, and I couldn't empty it no matter how hard I tried. I didn't want to make the decision to go back to an ileostomy, so kept going and going. I was severely underweight, had no energy or quality of life. I finally lost the ability to make the decision this summer. I got so ill, fever, vomitting and pain, the choice was gone. I required 2 weeks of TPN to get strong enough to endure the surgery. Since than I have gained weight, have much more energy, and look and feel so much better. I don't love my bag, but have gotten use to it and accept it. It really has changed my life.

Good luck! I hope I was of some help.
Shari
Shari - almost identical to my experience the only difference is that I had the pouch operation in 2000, so I got 10 ten years out of it. But now I wish I had the stoma instead from 2000. The vomiting and pain was just plain awful! I felt that life was not worth living (for very short periods of time).

There is light at the end of the tunnel and although I was offered a stoma a few years before, I refused thinking if I get through one more blockage I'd be okay Smiler

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