That's a good question. 

I don't have mine anymore... But still would like to know. 

I can tell by where the pain is...in my case it is pretty distinct...my k pouch is much lower down...I can feel the difference between gas in the tummy or small intestine or pouch.

Not sure if it is because I have had it so long or because they are really that different or maybe my brain had gotten used to it.

I do remember in the begining getting phantom pains followed by a major panic attack everytime that I would get a pain or cramp....that has eased up over the years and my brain recognizes the real pains from the fake ones.

Sharon

I think it's the location and the type of pain.  Stomach aches are higher and just below the ribs toward the left side, often accompanied by nausea.  Ulcers are sharper pains, often in the diaphragm.  Pouch pain is in the lower abdomen.  For me, pouch pain is a continuous ache, but if it is an obstruction, it is a sharp stabbing pain.  But as I have learned from this forum, everyone is different, so others may have different stories.

All I can tell you people... If you have an obstruction the pain is worse than Pancreatitis or kidney stone pain. Just released from a 3 week stay in the hospital from a small bowel obstruction in which I almost died. Can't believe I just said that. The obstruction came from adhesions. 

The good news is that I'm home happy and pain free ... Ohhh and pooping again��. Lost sooooo much weight (my weight is 85 lbs.

gained 2 lbs. ��

i have the BEST husband and grown kids and the best docs and nurses. I'm truly GRATEFUL to be here and one "luck lady"❤️

Janie, Glad to hear it ended well for you!  I went through the same thing about a year ago.  Had to have emergency surgery.  Apparently part of the small bowel was twisted and dying.  Very scary.  I went down to 94 pounds and have gained about 7 pounds a year later.  Still can't eat much or I feel sick.  Pouchitis is still a problem, but I, too, am grateful to be here!

Yes to you two who've endured obstruction - have been there too - twice - and so glad to have survived it.  Poucho - I think knowing if it's pouch pain or stomach pain is probably something you sort of figure out over time as Sharon mentioned above.  I can tell the difference for the most part - three types:  stomach, small bowel pain, and pouch pain.  And, I've learned to try to describe the daily amount of pain as "discomfort" - did that in my head to survive all these years and it worked!  That pain from an obstruction is horrific  - amazing we've all gotten through it and to the other side.  Poucho - I know your take down is coming up soon - we are thinking of you!

I thought I responded to this, but I guess I got distracted before hitting the "post" button. 

Basically, as stated above, location is your best clue.

The stomach is above the navel, the gallbladder under the ribs on the right, the j-pouch is low in the pelvis against the sacral spine. Pain originating in these areas will often have a localized effect. Sometimes, though, it is more vague.

If the pain is more widespread, it is more likely to be a generalized gastroenteritis, like you get from food poisoning or gut virus. Pancreatitis pain can refer to the back.

But, besides all this, a big factor is your own history. Once you've experienced something multiple times, you begin to recognize your own symptoms. Even then, you can still be fooled.

Jan

thanks Jan