Hi, Pouch2021! Some of what you’re going through is normal adjustment, of course, but getting used to the idea of a “stable leak” isn’t the usual course, nor is your spiky golf ball sensation. You might have an anal fissure, which tends to cause that sharp sensation in the anal canal. One part of adjustment that can be tricky is getting to know which sensations actually indicate a pouch that should be emptied vs. what might be thought of as false alarms. This can be particularly tough when other things (e.g. a fissure) are going on. Nevertheless, that’s kind of the project, along with coordinating the muscles that have to operate a little bit differently than before. It will be easier not to strain if you aren’t tempted to try to empty a pouch that doesn’t contain much. Ideally you will gently explore how your new plumbing works, so the uncertainty will diminish around what will happen if you ignore a particular set of sensations. Good luck!

In my own experience, that horrible “golf ball with spikes” feeling was the result of pushing. Unfortunately it took me over a year to figure that out, and that was while using biofeedback and pelvic floor PT. I’m over 3 years out and I still strain sometimes.  My mind always thinks a pop of gas or this great release is forthcoming and I’m usually disappointed and then pay for it.

Thanks both. I considered a fissure and definitely have an inflamed hemorrhoid but not severe pain with defecation which I would expect with a fissure. I will definitely be mindful of straining.
I’m almost disappointed that this anal pain and heaviness is not par for the course with a new pouch as I was hoping it would clear up without having to worry about yet one more thing going wrong. So did most people find the initial break-in period pain free? My butt hurts!

People have all kinds of post-op experiences, and the first few weeks are usually challenging in one way or another. Your inflamed hemorrhoid may be causing a lot of your problem. If part or all of it is internal it could be causing the golf ball feeling. This too shall pass.

Wow, you certainly have had quite a saga! I can relate to the pelvic abscess, though. I had one following my 1-step j-pouch in 1995. I had severe rectal pain like a hot poker up the butt and a fever of 105. It was treated with a drain, but rather than repeated drainage procedures, my drain was sutured in place and I had it for a minimum of a month. I had weekly CT scans and the drain was removed after the abscess pocket completely collapsed. Lucky for me, the leak was short lived and did not recur.

There are a number of people here who have issues with sinus tracts that intermittently abscess. As long as the flow back and forth is open, it usually is not much of a problem. But, if it obstructs and abscess forms, you are back in misery. One permanent repair can be opening the tract to the pouch. If the sinus tract is too long or complicated, then pouch redo may be the only option. I think it is way too early to know if this will be in your future. Fluid collections may or may not be problematic and as long as there is no infection present, they will probably take a watchful waiting approach.

Personally, I think your history is so complicated that you really cannot compare your recovery to others who have had typical outcomes. That said, I myself did have a lot of rectal pain for months post op. It was a long time ago, so I am fuzzy on the details. It was probably a year before my strength and stamina was restored.

Jan

Water would usually clear up any anal pain I had and not over eating and getting enough fiber. I am not sure if that would help your case though.

I am sorry you are going through all of this!!! We all have our trials and tribulations unfortunately. I will keep you in my prayers! I would definitely express all of my concerns and pain to the doctor and see what he says.

Keep us updated and I hope you get better my dear