There’s a big difference between a full pouch that can’t be completely emptied vs. a pouch with a small volume of stool accompanied by a feeling of fullness from another location. It can be hard to tell these apart, but the difference is important. What happens if you delay a bathroom trip for a while (at least an hour or two)? Did this new problem start after you started one of your supplements (peppermint or VSL), or fairly recently?

Dear Scott,

Many thanks for your reply and apologies for the delay as I am from the United Kingdom.

of course the difference is hard to tell. The feeling I get is when I empty by pouch I don’t feel completely relieved I just wish more would come out and my belly cramps and makes noises. I have been taking VSL3 for years now, and have been taking peppermint capsules intermittently for years also so I don’t think they’re the cause  

Another issue is orally I can’t take many medications- since my surgery oral medication tend to almost always give me nasty side effects. Even my iron supplements I take via infusion.

do you reckon its pouchitis, diarrhoea or abdominal spasms? Very sorry to burden you and thanks again for your kind reply  

best wishes

Mary T

Hello Mary T,

There’s a medication that relieves bowel spasms called Buscopan (hyoscine butylbromide). You could try a small dose and see whether it helps your symptoms.

It is taken as an oral medication usually, although in hospital it is sometimes given as an injection. You mention that you don’t tolerate oral medications well, so I’m not sure whether you could try it.

I don’t think it is meant for long-term use, and please check with your doctor and read the patient info sheet carefully before trying it.

If it is suitable, maybe it can be a way to check whether the problem is spasms or not.

I take it very occasionally for painful spasms.

It does have one side effect that I’ve noticed, which is making your mouth dry on the night it is taken, but this goes away the next day.

Regards,
Sarah

Thank you so much for commenting Sarah, I’ll ask my doctor whether I can take this medication on a low dose.

many thanks again

Best wishes

Mary T

Mary, it might be best to get a diagnosis before trying to zero in on a treatment. Have you had a pouchoscopy or a doctor’s visit recently?

Hi Scott, I haven’t visited my gastro for a few years, and that includes a pouchoscopy too. I already booked an appointment soon to see a gastro.

many thanks for your reply

Mary T

I wouldn't be surprised to find out you have at least low grade pouchitis. Mine always starts out slow and I don't realize what is going on. Hopefully you can get a better answer from a Dr. Probiotics can make you feel extra gassy/uncomfortable if pouchitis is building.

Good luck

Thank you ever so much for the reply PouchLogic, your advice is very helpful indeed. I suspect my doctor will put me on a course of ciproflaxin as that tends to be the antibiotic of choice in most occasions but I’ll see what he says.

best wishes

Mary T