Skip to main content

Hi everyone,

I used to frequent this site often prior to surgery but have been feeling good and haven't visited in a while. I had both my surgeries 7 years ago and haven't had any issues until 3 weeks ago. January 2nd I went to the bathroom at work like normal, I had no pain or urgency, it just felt like a normal bm but when I looked in the bowl I noticed there was bright red blood. I left work went home and had 3 more episodes of bleeding and decided it was time to head to the ER. I had another 7-8 episodes in the ER all blood and no stool. I was admitted and the bleeding stopped on its own that night. The next day I had an upper and lower scope which only showed some mild inflammation and a couple of ulcers in the pouch. I took a course of flagyl/cipro for atypical pouchitis and had an MRI this past Monday which looked normal. I'm going for another scope at the end of February. Right now I feel okay but have a weird feeling in my rectum after I move my bowels it's not pain but more of a discomfort (no pain while having a bm). I also have noticed some mucus with some bms. I have no urgency but am wondering if I might have cuffitis. It's a very weird situation as there was no warning and even when I had UC I have never saw blood like that.

Just wondering if anyone has experienced anything similar?

Thanks,
Matt
Original Post

Replies sorted oldest to newest

Hmmm...if you had cuffitis, I would think it would have been pretty easy to tell, even without a scope. When they do the digital exam prior to the scope, they are feeling the texture of the anal canal and rectal cuff (along with dilating your sphincter to ease the passing of the scope). If there was any cuffitis, the mucosa would feel bumpy. The more severe the inflammation, the bumpier the cuff would be.

It is possible that you have some very mild cuffitis, but that would not cause serious bleeding, just signs of irritation (bit of urgency, frequency, etc.).

You mention that there were a couple of ulcers and I would not be at all surprised that was the source of the brisk bleeding. All it takes is the erosion of a small blood vessel and you can have some heavy bleeding, which can stop as suddenly as it begins. That weird feeling may well be the pouch twitching and spasming after evacuating. Perhaps still touchy from those ulcers. The mucous is consistent with the pouchitis too. Was the ileum beyond your pouch checked during that scope? Just wondering, in case you might have some prepouch ileitis, or even a pouch inlet stricture...

Jan Smiler
Thank you Jan for the reply. During the flex sig they did look above the pouch and there was not any inflammation or ulcers it all looked normal (they kept throwing out the possibility of crohns which is why I had the MRI). Currently my stool is switching from too thick to loose without any rhyme or reason and I notice the mucous more in the afternoon/evening. My rectum is sore and I'm wondering if that is a combo of the scope and my stool being not back my norm yet.
You should be fully recovered from the effects of a scope within a few days, so I don't think it is that. The topsy-turvy output could be causing some trouble. I wonder if you have a bit of bacterial overgrowth, which gives symptoms of pouchitis without pouchitis being evident on scope. Maybe a longer course of antibiotics is in order, especially since you had those ulcers.

Did they say why they wanted to repeat the scope so soon? Since it seems like the bleeding has stopped, I would be hesitant to go poking around again so soon.

Jan Smiler
I'm not sure why my gi wants to do the scope again other than he said he wanted to make sure things aren't worse in there. It will be just about 2 months since the last one they did in the hospital. Also, in the hospital it was not my gi who did the scope but the covering gi so I'm not sure how familiar he was with pouches so I'm wondering if my gi wants to see for himself what is going on. I was up 4 times last night which is not normal for me I usually go 0-1 times during the night. There wasn't urgency just gas that wakes me up to go but the consistency was regular to loose throughout the night. If I don't see any improvement today ill give him a call tomorrow to see if he thinks another round of cipro is in order.

Thanks,
Matt

Hi,

just want to continue this thread since the biggest problem with my j-pouch is bleeding. Just to summarize shortly (and apologies if I have some grammar mistakes, typos, etc. since I am not a native English); I had my surgery already 2003 (directly to j-pouch) and after 2 month recovery I went back to work. I didn't noticed any significant problems with j-pouch after that, but after one year, i was hospitalized for another reason, and they found out that my hb was only 80. So after that they discovered that there is a very small part of the j-pouch which seems ulserative and had caused a small bleeding which then had lowered my hb to 80 and i normally have pretty high hb like 160-170.

After that, I have needed to monitor my blood and have needed to take some supplementary iron in order to keep the hb in good levels.

However, I had never had any massive bleeding, just some traces of blood sometimes in my stool, until i had a scopia on year 2013 and the doctor was trying to solve the problem by using the electronic equipment to burn the area, however, after fee hours it caused a massive bleeding and i needed to take to hospital for a two weeks, i was given a blood since my hb went to 80, and totally i was off from work around 3 weeks.

After that, the situation has been pretty same, no big problems, small bleeding but treatable with supplementary iron.

Until this summer, I had back problems and i took some ibuprofen and most likely because of that, i had again a massive bleeding which brought down the hb to around 100 within just few days, and the starting level was at around 160.

Now, this morning, i once again had some clear blood in my stool. So I am starting to be very worried since i don't see any reason why it should start the larger bleeding again, since i don't use any ibuprofen at all. I am starting to be very worried about my situation.

Does anyone have had similar problems and could advice me what could be done?

Thanks

wesley 

Any ulcer in the pouch (or the rectal cuff) can erode into a small blood vessel and cause plenty of bleeding. It usually stops on its own, but sometimes needs medical attention to stop the bleeding. It's best to think of this as two separate problems: First is the bleeding, which might need to be stopped, replenished, treated with iron, etc. Scond is the ulcer(s), which might be from pouchitis or cuffitis, either of which should be treated. A simple pouchoscopy gives a pretty clear picture.

Ulcers aren't the only thing that causes rectal bleeding, of course. Hemorrhoids are a very common cause, too.

Update from my situation. I had a scope this morning and the doctor said that there are ulcers that obviously have caused the bleeding. But he also said that he does not see it as pouchitis (at least I understood this way, we have a little bit translation problems with the doctor). He prescribed me 10 day Ciproxin and Mesalazine. This is the first time after my surgery (2003) that i have been prescribed Mesalazine. So is my colitis ulcerosa having a revenge..??

Any advice etc anyone to my situation? 

One questions more: how about disability? I know that it variates between countries, I am from europe but if anyone had experience how difficult is to be able to go to disability with j-pouch. I'm starting to be very depressed since i try to work, but my j-pouch does not like it. And it's very difficult to perform on work if you need to worry about your health, and be on sick leave quite often, like i am for the rest of the week.

The doc prescribed Cipro, which suggests that he considers pouchitis a possibility. The mesalamine (mesalazine) suggests that he also considers cuffitis a possibility. Cuffitis is like ulcerative colitis in the small rectal cuff that the J-pouch is attached to. Cuffitis is much more likely to bleed than pouchitis. Maybe you could get a copy of the doctor's record to facilitate translation?

A J-pouch is not a disability. Some people with J-pouches that don't function well may be disabled, and some folks here have successfully applied for benefits.

Last edited by Scott F

Add Reply

Post
Copyright © 2019 The J-Pouch Group. All rights reserved.
×
×
×
×
Link copied to your clipboard.
×