Hemorrhoids vs Cuffitis

Hemorrhoids are swollen blood vessles around your anus, preparation H should help relieve the sysmptoms. Cuffitis is an inflammation and is UC along the inside where your j-pouch was attached to your sphincter muscles. I'd guess an inch or less. It gets swollen in the area but you have to insert your finger, to feel it. It works better if you wear a surgical glove with some lubricant on it. It doesn't have to bleed and isn't usually caused by food.

Have you tried prep suppositories? Use some lubricant or vasoline when inserting and it will help. If you have cuffitis it shouldn't hurt it. It won't make it go away but won't hurt it.

Is there any chance I could have an abscess? I haven't had surgery in many years. The pain is limited to one area of the anal region. It comes and goes throughout the day, even when I'm not in the bathroom. Passing stool doesn't make it feel worse. Hot water helps with symptoms. My stool isn't watery, so I don't think it's pouchitis. Also doesn't seem like the cuffitis I'm used to getting. I'm hoping they're hemorrhoids that will heal; I've only been eating soft food for the past few days (fish, chicken, rice, stew).

Thanks for your response, Marie. I haven't tried suppositories yet, but I've been using hydrocortisone cream mixed with benzocaine. I'm also taking Bentyl at night to alleviate the spasms.

I have a similar question about cuffitis. I have recently had increased urge with some bleeding (although the bleeding seems to have subsided) and increased anal pressure. I do not have a fever and do not feel crampy or ill. My surgeon is not available right now. I have some mesalazine suppositories. My question is, should I try using them to see if it is cuffitis? Would there be any harm in trying if it is not?

Some of your symptoms sound eerily similar to mine.

I had 20ish years with little issue. In 2012, I started feeling "off." Couldn't put my finger on it... just "off" in a GI way. Sort of bloated. Sort of just not right. Low grade temps started. Kept saying to my hubby, "Something is wrong, but I'm not sure what is."

December 2012, I developed a perianal abscess, after straining a lot (maybe because of simmering pouchitis; hard to say for sure). Surgeon feels that it was straining that caused it; GI that specializes in IBD and J pouches not so sure, and like me, questions Crohn's or something similar (and I'll elaborate). Scopes have never have been horrible, but I spent time on Cipro a few times over these two years anyway (for both possible pouchitis symptoms and also abscess/fistula issues). Abscess turned to a fistula. That's a long, sordid, awful story unto itself, and I'll spare you the details.

But it was a one sided pain, however, the abscess started as an anal "bump."

I currently am *still* searching for a real dx, but we're getting closer.

I now have anal pain on the opposite side, but internally, on the LEFT. And today, my C-reactive protein and sed rate (inflammation markers) are elevated. CRP is 3.01; sed rate is 23.

I still run low grade fevers. I have tenesmus at times, where I have urgency and can't get off the toilet. Hot water helps ME, too. I couldn't survive without my sitz bath or a hot bath, from time to time, to calm things down. The left sided internal pain, when I feel in there, does have a bumpy area, so not sure if it's cuffitis or something more. But there's something happening, there's BEEN something happening, for 2 years!

Anyway, my GI is pretty awesome. He said that he wishes he could tell me differently, but he said there are many, many "old" pouchers like myself coming to him with very similar issues to mine. He's saying that it's not clear if we're truly "Crohn's converts," or if it's really that you can't take the genetics away, and when the pouch becomes more "colonic" in its pathology, the body is beginning to attack it in similar ways like with UC. He said he can send samples of old pouches to the pathologist, not tell them it's from a J pouch, and the pathologist reads it as "colon."

I have an exploratory under anesthesia on 9/15, and after that, we'll make a plan. A very quick taper with steroids this summer made me feel AMAZING, so he said he was certain that I have inflammation, and my blood markers secure that now. He's tossed around Humira for me, because of my fistula, too, thinking that maybe a biologic will heal the fistula, and help with my other issues. We're not there yet, but I'm hopeful.

Anyway, hope YOU *only* have hemorrhoids!!!! I was not so lucky.

I am having similar feelings but am only four weeks out of my takedown. I describe it like someone crumpled up a piece of paper and stuck it up there. When I had my exam before my take down she said my cuff ws inflamed slighty which she sid happens in 20-30%. is that cuffitis and will it go away? I have a very small cuff left, 1cm. I get the throbbing too, especially when I lay down. my stool is very formrd and copious so I thought maybe the anal canal is irritated, but it feels one sided. What is a fissure like? i kind of had the same feeling on one side before surgery. I am taking loperamide, and went down to metamucil once at night because i felt I was going too much.

Rachel, I really appreciate your detailed reply. I've read some of your other posts, and it seems like you've had quite an ordeal. I wish you the best of luck with the exploratory next month.

I examined myself to see if anything looked particularly abnormal, but nothing looked alarming. I don't have a noticeable bump per se, but when I press on a specific area, it feels like there's something relatively hard under there compared to when I press other areas. It hurts when I press on this spot. Standing up, sitting down, moving around in bed, etc. can trigger the pain as well. The interesting thing is that if I'm just sitting, standing, or lying down (i.e. not moving), I often don't have any pain.

This is all so strange because I had a pouchoscopy a week ago, and everything was fine except for some mild inflammation in the pouch. I wasn't completely cleaned out, so the doctor inserted a K-pouch-type catheter into my j-pouch to wash out the contents. It REALLY hurt when he inserted it; it felt like it was scraping my anal canal. I have no idea if this is related to my current issue, as this pain began approximately three days ago.

Anyways, I called today, and they gave me an appointment for tomorrow. I'm worried that there's something seriously wrong because I've never had this type of pain before.

Rachel, what you wrote about UC and genetics reminded me of this article I came across just this morning on another blog. Thought you (and maybe others) would find it interesting!
http://www.newswise.com/articl...s-in-gene-expression

Thanks!

Thanks for sharing your experiences with us Rachael. I found your GI's example of sending the samples to the pathologist very interesting. The pathologist said my biopsies from my last scope were all pouchitis. My GI diagnosed me as having cuffitis and pouchitis, even though the pathologist said the samples from the cuff,were pouchitis. I just didn't have ulcers or whatever as I treat my cuffitis aggressively with Canasa, mesalamine, suppositories almost daily. The pouchitis looked minimal but according to the CTscan and the X-ray with contrast my entire pouch was inflamed. He showed me pictures of my pouchitis and cuffitis as he visually diagnosed what was going on. Therefore what your doctor says makes sense to me. I go to the Mayo Clinic as my local GI sent me there years ago because of my complications.

allswell, if you stool is well formed you might want to back off of the loperamide some. I find looser stools are easier to pass. You are at a difficult time in recovery. It's hard to tell if what you are going through is part of recovery or if it is something wrong. I waited too long to seek help after my take down and when I did discovered I had several problems. Do you have a follow up appointment with your surgeon scheduled? I'd suggest you call and make an appointment. Better safe than sorry...

Scopes can really irritate our pouches sometimes, especially if we have something going on inside. How did your appointment go John?

Sorry for the delay in responding guys. My follow-up appointment went well. The doctor found nothing wrong with the pouch or cuff. Within a few days, the pain disappeared.

I was fine for about a month. Yesterday it came roaring back with a vengeance. I have a feeling it's related to the pudendal nerve. The pain is terrible. I'm going to try to see some sort of doctor about this ASAP.

Does anyone else have problems with their pudendal nerve?

I'm glad your pouch is ok John. I looked up the pudendal nerve and see that some of the suggestions included sitting on a blow up donut ring to relieve pressure. I probably had some paid due to that for at least 18 months. I still use my blow up donut when riding long distances in the car and when setting for very long on hard chairs. I bought cushions for our solid wood kitchen chairs too. The donut is especially helpful when I'm having tailbone pain during pouchitis.

You pain sounds a lot worse than mine ever was. It probably doesn't help you feel better now but my pain gradually got better.