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I keep getting this horrible lower back pain every couple of weeks that last for several days and just goes away. it feels like a heavy throbbing with pinching quick bursts of pain down my leg. since i have a sinus tract, Shen stated that signs of abcess would be horrible back pain and high fevers. I have not had any fevers and like i said this goes away on its own after several days but keeps returning. I have my annual scope with him on Thursday so i will ask him. could this be ANKYLOSING SPONDILITIS ??

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Poucho
I am sorry you are dealing with this. I hope you post back as I have similar symptoms that come and go and I'm going in this week to be checked for a fistula. Is that the same as a sinus tract? I believe I may have had an internal snail abscess that burst a few days ago with passing blood etc and my pain since has been pretty bad. I kept thinking all my symptoms were cuffitus related but now I'm skeptical ESP with the throbbing anal pain I had the last few days before the bleeding. Good luck with your exam. I am not sure how they diagnose the other. Possibly by symptoms and X-ray.
J
I would tend to think that this is a sciatica type pain, possibly related to your sinus tract. It is consistent with the "swell and drain" cycle of sinuses and fistulas. The swelling cycle could cause nerve irritation.

AS is more of a constant pain, worse with inactivity and improves after you are up and active. I'm not saying it is not AS, but sciatica is very common in the general population.

Jan Smiler
Jan Dollar
Hey Jan, i was reading about sciatica nerve pain and this sounds exactly like what i have. I get those sharp electric shocks down my legs sometimes. In the past month i have had this twice, lasting roughly a week. And it does not get better with stretching or movement like AS should. I will ask Shen about it tomorrow before the scope what his feeling are on this related to my sinus. or if its just an unrelated sciatica issue. as of right now i am taking oxycodone to take the edge off. are there any kind of anti inflammatories i could take short term or would those not help this issue? thanks Jan
Pouchomarx
NSAIDs might help the sciatica, but you need to run that by Dr. Shen. The docs at Cleveland Clinic are pretty much opposed to any use of NSAIDs with a j-pouch because they have seen so many cases of pouchitis associated with them. Plus, the fact that you already have issues with your pouch, you should not independently take these without Dr. Shen's input.

For myself, I will limit use of NSAIDs to about 2 weeks when I am having an arthritic flare. If that does not snap me out of it, then we have to go with steroids. In your case, your best bet would be a referral to a ortho doc specializing in rehab/mechanics (physiatrist), to get a proper diagnosis and treatment plan. That is what I wound up having to do when I had escalating neck/shoulder/arm pain with tingling/numbness. Turned out to be a pinched nerve root and severe spinal stenosis. Once the inflammation went down and I learned what movements to avoid I have been pretty much OK. Tried acupuncture but that did not do much for me.

Jan Smiler
Jan Dollar
had my kneedle knife with Shen and here is what he found and his thoughts.

First thing he found was my inflammation in cuff and everywhere else in the pouch is completely gone.He is taking me off the Entocort right now.

he stated my sinus has improved from the previous kneedle/knife therapys and performed it again. He will do one more in roughly 6 weeks.

Here was the problem. The back pain i was experiencing was maybe caused by the small sinus he found at the tip of the jpouch leading to the deep presacral sinus. He used a Bear Claw clamp to close it off and will check it on next scope.

his overall thoughts were that we are making progress and he is optomistic regarding my pouch.

I would be ok with this but these procedures are expensive even with insurance.
Pouchomarx

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