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Hi everybody, 

Today was my first scope, one year after takedown surgery. All looked pretty good except my doctor said I had white patches all over my jpouch and just above my jpouch. She said it’s one of three things- pouchitis, lymphoid aggregates, or crohns. I’m kind of freaking out, wondering what this may be!? She biopsied everything of course but I won’t know the results for 7-10 days. Hoping it’s not crohns. My jpouch is great other than it not emptying properly. I have no pain, no bleeding, no urgency, no frequency, I only have a bm about 4 times a day. All is great with my pouch except troubles emptying it. I always have to push and strain, even if it’s liquid, although liquid is a lot easier. I have now caused myself a mild vaginal wall prolapse, yay me. I’ve been dilated in the office for a stricture once and then was dilated today with my scope but my doctor said it barely needed it and shouldn’t be causing the emptying problem. She did say my sphincter was incredibly tight. Even with the twilight medications, she would expect the sphincter to relax but apparently it didn’t...she said this may be the problem. Anyways, I’ve gone on way to long. My two main questions are “do you have white patches in your pouch that are not ulcers”? And if so, what did they determine they are? And second “what would I do for an incredibly tight sphincter that is not functioning properly”?

Original Post

White patches in my case were pouchitis. Cipro took care of them. 

My understanding is that an overly tight sphincter can sometimes be managed with pelvic floor physical therapy. Others here have dealt with the problem personally and can better advise - though they might skip over a thread called “Lymphoid aggregates.” I do wonder if Botox might sometimes be used for that, but I’m just guessing. It *is* sometimes used for anal fissures, but it works by relaxing (actually paralyzing) the muscles in a hopefully limited way.

Good luck!

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