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Okay folks. 7 year old j-pouch. Infrequently have trouble emptying pouch but tends to be an issue when I get stressed, eat too much roughage, etc.

I recently went to surgeons because I was spasming and requesting a prescripton for Levsin (hadn't needed one of those for about 1 1/2 years. I had been doing warm water enemas daily for about a week to empty which is why I called him.

Anywho, he did an anoscopy while in office and said I had created ulceration from the enema tip. Fine. Deal with that. Then...he said he would have to dilate me at my next scope which he wanted to schedule the next day (not possible due to work schedule but have it scheduled the 28th).

Should I expect to not be able to work after this is done? A lot of the posts I have read regarding dilation seem to indicate this is the expectation.

I really don't want to have it done. Really don't think it is necessary. Have managed just fine emptying pouch unless the above-mentioned conditions exist.

Advise? Help? Condolances?

Jen
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I have had about 6 finger dilations done because of an anal stricture. The scar tissue has finally stopped forming and it's staying open now. They were done in office quick and easy.

Not sure where your stricture is at. Did your doc want to sedate you to do it? Maybe yours is more difficult to get at? Just my two cents but I would have it done if your doc thinks its necessary. You will most likely feel a whole lot better afterwards. I know I did....it was so much easier to empty.
@mgmt10 - It must be pretty close to the opening because he detected it with his finger in office. Something about he should be able to get his thumb through opening but could only get pinky.

I understand what you are saying, but if I feel like I'm managing okay without dilation, why take a chance on possible side effects FROM a dilation? Guess I just have to dig deep inside and decide what I feel is best for me huh? *sigh*

Stupid UC!
Had my scope the 28th with dilation. Things are worse. I REALLY have trouble emptying now.

However, my biopsy results show pouchitis. Can having pouchitis make emptying harder? I actually wonder, after reading info on pouchitis, if I, in fact, really need to empty or if it is just the pouchitis giving me urgency making me THINK I have to empty?

Anyway, doc is calling in Flagyl. Willing to give it a try...

Jen
dilation should have helped to empty better after a couple days. He said he should be able to fit a thumb up there?? That sounds a little wide, but maybe he has skinny hands. My surgeon's thumb is huge!

yes, it is possible that pouchitis makes it feel difficult to empty because things are inflamed down there. It makes you feel like emptying more or not emptying properly with all the irritation. Try the course of antibiotics and see how you feel. With the dilation, pouchitis, and water enemas, things may just be irritated and need to settle down....good luck
Your situation sounds so similar to mine! 7 years with no issues then I had a bad stricture causing a partial blockage requiring surgical dilation. I had a bad case of pouchitis and ended up after several dilations, antibiotics, etc., at the MAYO being treated for chronic cuffitis. Don't mess around with this, while it could be a very minor thing, it may be a recurrent issue that has to be followed. I now do a whole regimen of creams, suppositories, Levsin, daily dilations with gloved hand, etc. to keep me at a "simmer" instead of a "boil". You'll want to make sure you distinguish between pouchitis and cuffitis because cuffitis is harder to treat (mainly because it is actually ulcerative colitis in the tiny layer of rectal cuff that is sometimes left during surgery). My pouchitis, they feel was brought on by chronic NSAID use. I no longer take NSAIDS so my pouch is great...it's the cuff that's the real pain in the a**, no pun intended, lol!

Hopefully the Flagyl will make you feel better. I can't take Flagyl as I have a violent reaction to it, so my GI gives me Xifaxin and occasional Cipro if my pouch acts up.

I wish you the best! Keep us posted and if you want more info, feel free to PM meSmiler

Alex
I was told I have cuffitis and given canasa and told to have pelvic floor therapy. Didn't think I even have a cuff since surgery was done in 1985 so then doctor said it does not specify type of inflamation. For 9 yrs. I was told pouchitis. I would be willing to bet the ulcers have always been in the same area. he also told me to eat more smaller meals and drink lots of water and drink can't remember right now what b/c I didn't see a difference. Its to make it more formed but soft. I have only heard about dilation on the site. No doctor has ever mentioned it to me. I saw a gastro at Mayo in Jacksonville the last time. Hope you get relief soon. I know how frustrating it is not to be able to empty. I had thought about using the warm water but thought it might cause the problem you mentioned eventually. I know about that b/c my step-daughter is quadrapledgic and use to do a certain bowel program until she developed an ulcer in the opening and can no longer do it that way b/c of keeping the ulcer aggravated.

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