J-pouch discharge 4 weeks post-op

Sounds pretty normal. I had to wait 4 months b/w surgeries, and it tapered off to nearly nothing by the time I had takedown. Mostly I remember the discharge being mucusy, not rusty, but that was years ago, and I might just be forgetting.

It sounds normal. Sometimes there might be a little fissure or bleeding at the anastomosis line.

I'm back... Now there is definitely blood mixed in with the mucus about 50% of the time. I am getting nervous because it looks a lot like my rectal discharge when I had active proctitis after Step 1.

Is there any way of distinguishing between cuffitis and normal post-op bleeding? I am going to call my surgeon tomorrow to ask but I am afraid he is going to put me off with the standard "it's normal to see a little blood."

Also, anecdotally I had intercourse for the first time since having the j-pouch constructed and it seemed like there was more blood in the pouch discharge afterwards. My surgeon swears up and down that sex shouldn't jostle the pouch or interfere with it in any way but maybe it could have irritated it somehow?? It was just the first time evacuating my pouch after sex that I saw a lot more blood, since then it seems to be back to the normal amount.

Any help or reassurances more than welcomed...

I think the mucus tinged with blood, etc. is just the way in which our body cleans itself out. I know how shocked I was when this happened but found it to be part of the new normal for me. Your doc can reassure you when he checks you. I was surprised at how much mucus there was! I guess without it we would be plugged up! Oh, at times, my mucus was grey, also! Once reconnected we hardly notice the mucus but I guess it is still there.

Thanks CC!

To close the loop on this one, I saw my surgeon and he performed a rectal exam as well as a mini pouchoscope. Pouch was totally clear but there was mild irritation at the anastomosis line causing the bleeding. He says it's totally normal and nothing to worry about -- bleeding might continue after takedown but I won't notice and it shouldn't affect pouch behavior etc. phew!