Help with diagnosing my problems

TravellerMember

Can anyone help me with diagnosing my problems. I am 13 months post 1 step jpouch surgery.
Symptoms
Pain during and after defacation
Feeling of incomplete evacuation
Increase in BM's from average of 6 to 10 over the last 2 months.
BM's a little loose at times
Bm's a little more urgent than before
Pouch never feels comfortable as it fills.
I have quite a few close spaced BM's each afternoon with quite a lot of discomfort in between.
Just started to feel a little run down.

I take 8 lomitol a day
3x benefibre
2x probiotic

Had a pouchoscopy 2 months ago. Pouch looked good.
I just don't seem to be able to get a diagnosis for what is wrong?
Any ideas would be greatly appreciated.
Thanks Gary

11/27/125:51 AM

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Jan DollarModerator, RN, retired

My guess would be bacterial overgrowth or IPS (irritable pouch syndrome). Both of those have pouchitis symptoms without endoscopic evidence of pouchitis. Bacterial overgrowth is treated with a short course of Flagyl or Cipro (7-10 days). IPS is treated with low dose tricyclic antidepressants and antispasmodics.

Jan

11/27/1211:31 AM

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TravellerMember

Thanks Jan

I have been on endep up until a few weeks ago, but it was playing havoc with my system. Have also just started on buscopan last week as the antispasmodic. Do you have any suggestions for which tricyclic antidepressant and antispasmodic to use? What is the prognosis for IPS? Is it something you have to always manage or does treatment and time cure it?

11/27/126:24 PM

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SubzeromamboMember

Jan, Have you heard much about treatments using Lactose Solution USP 20 mg twice a day for bacterial overgrowth?

11/28/1210:47 PM

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Jan DollarModerator, RN, retired

Buscopan is fine. Other antispasmotics commonly used are dicyclomine (Bentyl) and Hyoscyamine (Levsin). A typical tricylic antidepressant used is amitriptyline (Elavil). I am afraid that IPS is like IBS and you don't cure it, you manage it.

Don't know much about it other than Dr. Shen at Cleveland Clinic is researching it in his pouchitis clinic.

Jan

11/28/1211:02 PM

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