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First of all, I just want to say how WONDERFUL you all are! I can't believe others are having some of the same issues I am having. You have made a world of difference in my life.
Because of many of your recommendations I went to see Dr Shen last week, was up there for 4 days.
I've had my pouch for 20+ years and no real problems except some blockages until 1.5 years ago when diagnosed with lymphoma. I used to be in the bathroom every 1.5-2 hours and got rather used to it but now it's every 45 minutes oftentimes and it's hard to have a normal life that way. Also I was pushing so hard to get poop out and hardly anything would come out each time.
Dr Shen said it was due to 2 strictures, 1 above pouch and 1 below, a vaginal fistula ( the vagina is in communication with the rectum he said), which he says is one of the worst things he likes to deal with, and bad pouchitis. I was put on cipro,tindazole (sort of like flagl), and proctofoam. He talked about me being on the full strength antibiotics for at least several months which was a bit scary for me. Comments from you all on that??? I asked about all the bad bacteria I already had in my gut and he said he does fecal implants which I read about. He was very nice and I am to return in 1 month for another scope. If this doesn't work, 50-50 chance, he said he had some others tricks he could use.
Anyone else had a vaginal fistula or know much about them??? Thanks for your help.
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I actually see him this Friday. For similar things. I have a MRI Thursday and endoscopy Friday. I have a fistula and how does he do the scope? Bc I'm nervous about that and I am in pain. Dr. Remzi is my dr but he brought Shen in Bc he thinks I might have crohns or sinus tract idk I was quite out of it that day Bc it was the day I had an EUA
clouseau sorry you have so many problems. Dr.Shen is the best. If I were you I would follow his plan exactly as he wants you to. And then when he scopes you next, depending on results he may change up things. He always seems to have additional "tricks" in his bag.

and akk... you should call his office now and see if they can schedule you for a scope during your initial trip there. generally he would see you in his office, schedule scope and other tests, and then see you in the office again. He sees many many patients from out of town and they generally are very accomodating. So call now and see if that scope can be arranged. You must get through to his office, not the appointment scheduling numbers. If not, i would just plan on staying a night or two. Then once you are there.. Dr. Shen will be able to have you fit in for scopes or other tests he wants done.
good luck.
I wouldn't worry too much about the extended course of antibiotics. Although there are long lists of uncommon side effects, the side effects that commonly occur are generally manageable (e.g. yeast infections) or may require substituting a different med (e.g. if one gives you a belly ache). Many of us are on antibiotics semi-permanently, and barely notice it. What you're treating is likely to be worse than any side effects.
I saw Dr. Shen a couple years ago for a Pouch-Vaginal fistula, as well. He did put me on antibiotics - the tindamax (as well as canasa and hydrocortisone enemas for cuffitis). I've been on antibiotics since then. I had no side effects of the tindamax until I'd been on them about a year and then got some mild "tinglies", at which time he moved me to a different antibiotic.

After a few months on abx's, he tried doxycycline injections on the fistula, which didn't work in my case. He then sent me to a CClinic surgeon who placed a seton and that's where things stand now. Hopefully, your fistula is a simple one rather than complex, and the antibiotics will do their work. Otherwise, Dr. Shen will try everything he's got to treat it medically. Out of curiosity, how are your strictures being treated?

So sorry you're going through all this. Please feel free to PM me if you'd like to discuss anything in detail!

Best wishes
Passing air was a mild symptom in my case, although, looking back, I think I had this very symptom for a quite a while prior to everything coming to a head. Thought it was just a natural "thing" for us women. Roll Eyes It is definitely worse, as you mentioned, when the pouch is full and/or when there is more gas in general.

I'm rather surprised your surgeon didn't explore it further. Let us know what your GI has to say?
AKK3769,
I had a scope scheduled in the AM and consult in the PM that is the way he usually does it. I had to stay 2 extra days for an MRI to confirm the vaginal fistula and then had an apt the prior day again with him.

Liz11, thanks for your note, I will follow everything precisely.

n/a, For the strictures he did balloon dilitations. Amazing someone else in OH who has had vaginal fistula's.

RLC, My only symptoms were 30+ liquid like BM's a day, some inflammation outside vagina and yeast infections.
This must be the Fistula finding month for Dr. Shen. He found mine just a few weeks ago after being told I did not have one by my crs at duke. I don't have any idea what will happen next expect I see Remzi next month. I wish other GI and CRS would consider the important work he is going for people with jpouches. It is on thing to make a fortune making them...quite another to help a person live a healthy life with one long term. Keep use posted on your progress.

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