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Hey all, long time lurker, first time posting.

Anyway, I got my jpouch in March of last year, so I've had it for exactly a year and I've been struggling with it badly recently.

I've had pouchitis a few times and was on Flagyl for almost 4 months. When I stopped the Flagyl about 3 weeks ago, I was doing pretty good: Only going 4-8 times a day, no weird pressures or urges to empty, spasms were low - I generally felt pretty good and was happy to be off the anti-biotics and I started exercising.

First, medicine I'm taken

-100mg daily amitriptyline for pouch spasms.
-Probiotic 1 daily VSL#3

But for the past few days I have been so miserable. Starting Sunday I've been having these symptoms.

- Forced to empty pouch every 1-2 hours
- Forced to go after eating anything, bad spasms
- Pushing hard to go
- Stool consistency is runny not as formed when feeling good (despite eating bananas, oatmeal, apples for fiber)
- Immense burning when emptying (Trying the bile salt powder use to work, now it's not)
- Swollen/inflamed anus/anal area, particularly on the left side, making it very painful to empty
- Never feeling empty

I called my Gastro and she said since she pouch-scoped me last month and everything looked healthy and pretty great (she said I have one of the best pouches she's seen), that she has no idea what's causing this. I have no energy, I'm eating less, and feeling dehydrated because of these symptoms. I pleaded with her to see me, but she said it won't make a difference. I'm about to head to the ER, I'm in so much discomfort.

Getting a "I don't know" from the doctor is very disheartening. I know what it feels like to have a healthy pouch. This is not it.

The only thing she said we could try was to change my amitriptyline to a different anti-spasmodial. I don't think this will help, spasms/nerves don't explain the inflammation and swollen feeling.

So please, anyone that has had similar symptoms or can refer me to a doctor within or near the St. Louis area? I don't even know where to go. I've called a few doctors, but all of them have 1-2 month waits for new patients. I've barely made it 3 days. I'm just physically exhausted after a bowel movement.

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I wonder if you have a fissure. This could easily have cropped up since you were scoped last. Especially telling is the fact that your pain is localized, and not all over. Call your GI back and ask if he thinks it is possible, because the amitriptyline would not help much for that (it is not an antispasmodic by the way, but an antidepressant used for GI pain associated with IBS).

Fissures cause spasms of the sphincters, pain, an obstructed feeling, and general misery. Antibiotics help at first, because they slow things down, thicken stool, and reduce the acidy feeling.

Jan Smiler
Jan Dollar
I'm with Vanessa, you should be tested for c-diff, any doctor can order that test. If your GI doesn't know what to do ask for a referral to someone who does so his/her office can get you into a GI IBD specialist NOW.

If the problem is above what your doctor can handle they should tell you they can't handle it, like they did, and refer you to someone who can. That's the sign of a good doctor, one that's not afraid to refer, and a doctor's office can get you an appointment sooner than you can get one for your self.

Did you go to the ER? If you did, maybe they found someone to help you.
TE Marie
Hey guys, just wanted to update you. I wasn't able to secure an appointment with my GI, but I did get in to see my surgeon. He examined me and determined to be pouchitis (again). I'm on a 10-day course of Cipro and it's only been 48hrs and I feel miles and miles better.

Thanks for the responses, does anyone else here have reoccurring pouchitis? Not sure what I can do to help avoid it in the future. I'm on VSL #3 right now.

Thanks again
J
I'm glad you you are feeling so much better! Sometimes people have isolated cases of pouchitis. This doesn't mean you are going to have it chronically. Please time your probiotic and antibiotic usage or quit your probiotic while taking the antibiotic while taking it. Jan has explained why to do this better in the past.
TE Marie

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