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why is it that my cuff is still inflamed after months of hc suppositories? my gi prescribed small chained fatty acid enemas at approx $450 out of pocket a month. no way!!! still living on ensure shakes so liquid in liquid out. any solids back me up and cause straining. how do i get out of this cycle?
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Unfortunately, like UC, cuffitis can be resistant to any treatment. People who are unable to live with the chronic symptoms or wait for a spontaneous remission (may or may not happen), generally wind up either having pouch advancement surgery or opt for an ostomy.

There is also the option of systemic therapy, the oral meds used for UC or Remicade and the like.

Jan Smiler
Well, a pouch scope will only visualize the pouch. If you are having problems with any solid food, other than simple diarrhea, your problems may be anywhere in the GI tract, or be adhesion related. A pouch scope would not help in that case, except to rule it out as a problem. I bring this up because I cannot think of another person who could not tolerate any solid food solely due to cuffitis (and I have been active on these forums for over a decade).

As to whether Canasa or hydrocortisone is better for cuffitis goes; I think they are pretty similar in efficacy. Canasa has an edge in preference because it is not a steroid and so it is considered better for long term treatment. Personally, I did pretty well with Canasa, then switched to sulfasalazine (oral), with Canasa for acute flares. But, my best function dis not occur until I went on injectible biologics.

Jan Smiler
could it be my cuff isnt a problem at all but the pouch is trying to deal with a pure liquid diet? i do bleed but remember im on blood thinners for a blood clot. whenever i add like pb n j sandwiches i get a lot more frequency.

could cutting back on my hc suppositories possibly help like in jeans thread? maybe it aggravating my situation. i did have pain in the cuff area that has subsided since the hc's but now and then i get these intense urges to go and freeze in my tracks till they subside...
Well, peanut butter and jelly isn't as great as it seems, because it is high in sugar, which promotes diarrhea, particularly if your gut is used to Ensure. It is even possible you have peanut allergy, one of the most common food intolerances. Things like oatmeal, rice, tapioca, banana and applesauce are better transition foods.

It sounds like you are having spasms in your sphincters. I had those for a year or more post op. I don't know if it was the right thing or not, but I just tried to ignore them as much as I could, particularly since what I ate or didn't eat didn't seem to make a difference. Same thing with frequency. It is up to you how much you want to limit your diet, but I just ate what appealed to me and sometimes just paid the consequences. Eventually, my gut got used to it and things got better.

Again, I don't know what's right for you, but I would not want to live on Ensure unless it was an absolute necessity. I could handle diarrhea, but that's just me.

As to the bleeding, if the HC suppositories seem to reduce it, keep using them. If not, you may as well, stop them or reduce the frequency and see how it goes. Anticoagulants add another wrinkle to the mix, for sure.

Jan Smiler
Last edited by Jan Dollar

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