Betty, fatty stool normally floats. Is that what's happening? If not, can you describe what you mean by "fatty?"

Porridge is a nearly perfect consistency for stool with a J-pouch. Soft, neither liquid nor formed. Are you concerned about that?

Your pain sounds like anal fissure pain. Did your doctor mention or consider fissures? Perhaps a specific treatment, like topical nitroglycerin, nifedipine, or diltiazem would work better.

Good luck!

Hi Scott,

Thanks for your reply.  When I say fatty, I mean the bowl is full of fat/oil/grease floating on the water and on  a good day it's porridge consistency but generally its a greasy liquid with small sphere's of fatty stool, which are also floating and it is either bright yellow or sometimes (when more formed, ie: porridge) pale yellow.  The consistency never bothers me as I can always take psyllium husk if I want to thicken it.

It's definitely not fissures as that is what my surgeon looked for first, I did have open ulcers both inside and outside the anus last year but now it is just a little inflamed, although the pain is dreadful.  Could the fact that my output is fatty and looks like bile be making the pain a lot worse that it would be with a normal output?

Cheers

Bernie

Fatty stool isn't caused by a J-pouch. It can be caused by medications, olestra, or small intestinal, liver, or pancreas problems. The combination with excess gas suggests SIBO to me. None of this directly causes anal pain, though. I still suspect you may have a hard-to-see anal fissure, or perhaps a very painful ulcer in the area. You could try sitz baths without any cost or risk. Good luck!

I appreciate it isn't caused by the pouch, but in hindsight I have had the oily output for over a year but didn't take much notice as what comes out varies as to what you eat with a pouch.....I do know that every time I have been on ciproxin, the gas and fatty stool goes, but then after about 10 days the pain starts up again and eventually all my symptoms are back.

It's definitely not a fissure or ulcer as I had the scope last week and my consultant is the top man in this area (I'm in the UK by the way) I have not mentioned the yellow fatty stool and gas to him yet as I have only just considered it...I just wondered if it would irritate the inflammation which could explain the extent of my pain.  Sitz baths help but only for about half an hour  

Thanks again for your advice Scott.

Just thought I would post my results in case anyone has similar problems.  I had an ultrasound on my gallbladder and it showed a lot of sludge!  My consultant said I need my gallbladder removed as this seems to be what has been causing my anal pain, along with all my other symptoms.

Hopefully this will help anyone who may be experiencing anything like this.

Thanks again 

Bernie