Need Recommendation for Cleveland Clinic surgeon for yearly pouchoscopy

yeah I am not sure why all the good surgeons there have left? wish I knew what the problem is. they are #2 in nation and I am sure they will drop now due to all the great surgeons that left. Dr Remzi did my redo and he was best in the US and he also left this past August for NYU. Usually people see a GI for annual pouch scopes not their surgeon, even though some surgeons don't mind doing them, but they are know to cut since they are surgeons. I see Dr Bo Shen at CCF, he is considered the top jpouch specialist in the US if not the world. He is the very best. I have seen him since 2008 when my first pouch had a ton of issues. Hope this helps

I switched to a gastroenterologist. Some surgeons like to stay with their own patients long-term, but very few surgeons would choose to take a new patient for annual pouchoscopies.

I had my JPouch in 1985, but have never had a pouchoscopie, how important is it? I had my surgery done in Salt Lake City but lived in Boise , Idaho, and it was pretty new then, I don't think my Doctor in Boise knew that much, or maybe pouchoscopies were'nt invented yet! I have lived in the Dallas, TX area now for almost 20 years and have never needed a gastroenterologist. But I've been wondering if I should have a check up because it's been so long.

Cyndi, there are lots of opinions about periodic pouchoscopy intervals. A search can help you find them. Here's what I wrote last year, for example:

https://www.j-pouch.org/topic/p...7#513451354168904367

Cyndi,

You had your j-pouch due to UC and it has been more than 30 years since your diagnosis. So, at the very least you should have a pouch scope to verify that all is well. If you had dysplasia or cancer, you absolutely need scopes and biopsies. Also, if you have any retained rectal cuff (most of us do), you also need periodic scopes. So, yeah, it is quite important for you to be checked. Once you get established with a GI, he can determine what your interval should be. Remember, ALL cancer risks increase with age.

Jan

I remember after my surgery, Dr Kiran told me that he would see me once a year for pouch checks. When he left, he referred me to another surgeon, Dr Strong who told me every 1-2 years was fine. So I think it's definitely important. Just not sure how often it's necessary.  I know when I was checked, I felt absolutely fine, and was told I had ulcers and pouchitis. So I guess you may not always notice symptoms. Better safe than sorry 

It makes sense to see a GI doc. But after my surgeon left, I was referred to two other surgeons. So that's why I was confused as to whether to continue with colorectal surgery dept or find a GI doc. Seems like if GI usually manages it, he would have just referred me there.

I also see Dr. shen at CC for yearly scopes  and I had my BCIR surgery in St. PEtersburg FL. I think he sees more pouch patients that most DR.s--surgeons or GI docs. Since I am coming from out of town, I am able to get a scope with him in the morning and office appt in the afternoon. If you are not having issues, you probably don't need an office appt (he will talk to you after scope, but of course you are still kind of out of it!!)

One more thing I like about CC is when they say your scope appt. is at 8:30 am(for ex), the nurse comes out exactly at 8:30 to get you! They do your IV, vitals etc and then the scope starts at 9 am.

Wow! That definitely sounds like the way to go. I have had three scopes with two different surgeons. And I have never had an IV or any meds prior. I was fully awake with the doctor talking to me the entire time.  Hopefully I'll be able to schedule with Shen!!  Thanks. 

Obviously,  you must not have been experiencing pouchitis when the surgeon did your pouch exam. A C.C. surgeon did the exam when I had pouchitis, and the pain was unbelievable.  Later, I was referred to Bo Shen, and he promised a pain free exam with IV meds. I will go to Dr. Shen again in the future.

I'm sure there are different severities of pouchitis, depending on how much inflammation is present. Sounds like your case was definitely severe. I was treated with Cipro for several weeks after I was diagnosed. 

For a pouch exam you might consider Dr. James Church at Cleveland Clinic.  He is a colorectal surgeon and did my pouch procedure sixteen years ago.  He suggests follow up exams on a two year interval.