Kind of a dumb question, but something I was always curious about

Yeah dumb question.

Although I'm able to pass gas without a BM, the vast majority of J pouchers, including myself, pass gas during BMs and due to frequent BMs, 4, 5, 6 or more per day, I would assume it's unlikely for such a build up of gas to occur.

It's my belief, that if and when a blockage does occur, it tends to be where the small intestine becomes the J pouch or adjacent to the old stoma site, mainly due to the forming of scar tissue which results in the narrowing of that area; I dont believe the other end/opening becomes blocked, so there's always a means for gas to release.

The J pouch is constructed from a persons own small intestine and just as the likes of a pigs bladder or is it a cows, being used and inflated within a football;, I'd expect the intestine/j pouch has the same ability to stretch and expand, just like the stomach, large bowel and other areas of anatomy, especially during pregnancy and child birth.  

During my last UC flare up and before my colon was removed; Doctors said my colon was beginning to dilate and if not removed immediately, it will reputure, which would most certainly result in my death.

Prolonged bowel obstruction can cause perforation. I don’t think anyone could do this voluntarily, though.

I am with Scott. An obstruction could lead to perforation, but not intentionally “holding it in.” It is right up there with holding your breath until you turn blue. Your body won’t let you do it.

Jan

There are no dumb questions. 

Just answers. Lol

None here. But in general.

Richard.

Am I missing something here.... the op asked could purposedly retaining intestinal gas within the J pouch cause it to burst... !

From a J pouch point of view, how can the  J pouch its self become obstructed ?

Both post after my response, seem to imply that my thorough explanation, reasoning and opinion is wrong.

It is true that complete obstructions of the pouch are uncommon, do occur. Most obstructions occur higher up in the GI tract for us, but the pouch can become obstructed if there is a stricture, especially if there is a build up of fiber. Also, if there is a prolapse, the outlet can become obstructed. 

Jan

Jan Dollar posted:

It is true that complete obstructions of the pouch are uncommon, do occur. Most obstructions occur higher up in the GI tract for us, but the pouch can become obstructed if there is a stricture, especially if there is a build up of fiber. Also, if there is a prolapse, the outlet can become obstructed.

Jan

Must admit. I never thought of a prolapse.a

Was my original response to this post incorrect ?

You're happy to concur with Scott. which appears to imply that my response is wrong.

Even the response provided by Scott, is worded in such as manner it appears to be a correction, although. I never even mentioned "prolonged bowel obstruction"

Strange, I was replying to the OP, not to your response.

Scott F posted:

Strange, I was replying to the OP, not to your response.

Same here. 

It wasn't directed at you. 

I apologize if you thought so. 

It was just in general.

Richard. 

Strange, your post was mostly correct, but with some incorrect assumptions. The walls of the GI tract are not the same throughhout. The small bowel is thinner and the colon has thicker musculature. So, the small bowel is more fragile and more likely to perforate under pressure. Dr. Shen has noted that pouches have perforated by heavy lifting.

The primary point was that while perforation is not impossible, it is impossible to voluntarily do it. Nothing is ever as simple as it may seem.

Jan

Jan, thank you for being good enough to reply.

My initial reply; is a generalisation of my understanding of the internal organs and anatomy, gleaned from elements of personal experience too.

There are no stupid questions. If you’re thinking of it, ask. I’m sure others have thought of the question too. That’s what this site is for, after all  

No problemo. We are all only armed with our experience and knowledge base. The main thing I have learned over the years is that each time I learn something new, I find there is so much more I have yet to learn.

Jan

Jan Dollar posted:

No problemo. We are all only armed with our experience and knowledge base. The main thing I have learned over the years is that each time I learn something new, I find there is so much more I have yet to learn.

Jan

Well, I believed it was a dumb question; and only a basic but knowledgable understanding of human anatomy would suffice.

I only replied as I believed it was posted by a child (teenager) and I didn't expect anyone else would reply.

Although a lot of you have focused on obstructions, gas and other causes, the most obvious and common cause of weakening of the intestinal wall is inflammation.  I know this from looking at MRI Enterographies and discussing with my pouch doc. In 1992, after my colon was removed, my surgeon told me it was so riddled with inflammation that it was "dissolving in his hands".  He then admitted to me the surgery should have been done on an emergency rather than elective basis.  Toxic megacolon, and perhaps death, were in my immediate future if surgery had not been scheduled when it was.  And it was delayed for months because my surgeon wanted me to lose 10 pounds from 170 to 160, at that time.

If a pouch is riddled with untreated inflammation, for reasons mentioned by Jan, the wall of ileal tissue is even more prone to perforation than was my inflammation-riddled colon.  A big area of concern is the Pouch inlet, which in my MRI Enterography was the most inflammed area. Whether perforation could happen from sneezing, vomiting, hiccuping, holding gas, straining on the toilet, vigorous stretching exercises, or sexual activity is anyone's guess, but if the tissue is irreparably weakened and is about to tear, it's eventually going to tear with a trigger activity.  The only thing you can control in this equation is treating the inflammation in the first place, and not letting things progress that far.  In my case 60 mg prednisone was not doing it for the colon and biologics as we know them now did not exist except for Imuran which my liver spat like a young child tasting liver for the first time.

I would think perforation is unlikely with healthy ileal tissue, even if it is weaker than colonic tissue.

Strange, I do not wish this to become a debate, so do not feel the need to reply. However, it is best not to make assumptions about a member. Would it matter if it was from a teen or someone with less education? People come here to communicate in a safe and welcoming setting. While no reports were made about the original post, there have been about your most recent reply. I am going to assume your intent was not hurtful, but it still comes across that way. Please try to avoid making those comments.

Enough said.

Jan

Jan Dollar posted:

Strange, I do not wish this to become a debate, so do not feel the need to reply. However, it is best not to make assumptions about a member. Would it matter if it was from a teen or someone with less education? People come here to communicate in a safe and welcoming setting. While no reports were made about the original post, there have been about your most recent reply. I am going to assume your intent was not hurtful, but it still comes across that way. Please try to avoid making those comments.

Enough said.

Jan

Jan. I could not agree with you more.

 Here in the UK,  I regard it as a silly, child like question and I assumed "'dumb" meant the same in the US..... me and my assumptions;  I wasn't criticising or attempting to belittle or discourage the OP.

I'm not saying the questions is so silly or dumb to the extent that it should be ignored or not asked, regardless of an OPs age, otherwise I would never of replied.

I just believed that answering a question of such a nature didn't warrant a wealth of medical knowledge or expertised.

Nuff said