Ok. Some new developments. Need some answers.

I’m glad your partial obstruction passed more or less uneventfully, and I hope you’ve seen the last of it! As far as the gurgling goes, is your concern chiefly about the implied threat of more trouble, or the noise itself? Do you have any discomfort, or any sensation at all, associated with the gurgling? That can sometimes help localize the issue, often suggesting that it’s not related to the J-pouch at all (and making a pouchoscopy often unhelpful in explaining it).

The adhesions don’t tend to go away by themselves, so the section of gut that gave you trouble in April is quite possibly still being tugged on a bit - not enough to make you miserable, but enough to bend the channel and make a bit of noise as stuff moves through. It might find a more stable/less tugged-on position over time, and then the gurgling would quiet down. As miserable as partial obstructions due to adhesions are, unless they become frequent the best plan is usually to live with them (and keep yourself hydrated during them). The only treatment (surgical lysis of adhesions) carries a risk of making the problem worse, so the problem has to be pretty bad to make that a sensible gamble.

Thanks Scott! I was actually wondering the same thing about a pouchoscopy, since the issue is higher up than the pouch.  The gurgling is mostly around the stoma site, which is the same area that was giving me problems back when I had the series of partial obstructions in 2014. Those as noted eventually settled on their own. As you pointed out, we opted not to do surgery at the time given the fact that adhesions often beget more adhesions,  not to mention the fact that I would much prefer to avoid further surgery as far as possible. I've always had some degree of gurgling since my takedown, but following this most recent obstruction, it's quite loud and much more frequent, and I can feel movement in the area. Sometimes there is a very slight twinge of discomfort, but nothing substantial.  Also it's a bit hard to explain, but sometimes if I press on the area and massage it, I can hear/feel a sloshing sensation, similar to if you drink too much and feel liquid in your stomach. That really isn't entirely new, but I think I am just more aware of it now.  My primary concern is the implied threat, since I haven't not experienced similar symptoms to this degree before.  Although, the gurgling is loud so the potential for embarrassment is there. Otherwise it's not really interfering too much with day to day activities. I'm a little more careful with my diet, of course, given the obstruction. I would just like to have a few more answers as to why the symptoms have persisted now more than a month since the obstruction passed, and wondering if there isn't something else brewing.  Obviously the fact that the CT didn't show any major issue is a bit reassuring; the ongoing symptoms are not.

So sorry you are going through this, I am glad you are better. I hope you get your pouchoscopy and gyno work done soon.

I can help with the Anxiety: Think or say out loud the things you are grateful for, that always helps my anxiety. Exercising especially helps my anxiety too along with breathing exercises

Hope everything gets better for you dear.

Sounds as if you may have residual swelling a d inflammation from the partial obstruction. Possibly complicated by bacterial overgrowth from the sluggish movement you had during this episode. It can take a while for the swelling to subside. Maybe another course of antibiotics is in order? And yes, massaging the sit is a good thing for keeping things moving.

Jan

Thanks Jan. I did suspect the bacterial overgrowth could be due to the slowed motility.  Would the residual inflammation have been visible on the CT? It was not enterography; only an abdominal CT with contrast (injection only, no oral contrast).  I was only able to speak to my surgeon briefly over the phone following the CT and he just mentioned there was no ongoing obstruction, and then the gynecology referral (I have a very large fibroid and a pelvic cyst).  I'm hoping to get a follow up with my surgeon soon. Again we're still trying to navigate through COVID restrictions and backlog, though things have been improving over the last couple of weeks.

Gee, I don’t know. CT is good, but I don’t know if it shows everything. I suppose the fibroid and cyst would also be enough to cause significant grief.

Good news is that things are better, so maybe you’ll never know. That is how it is sometimes (too often)!

Jan

Thanks Jan! As it is, I'm still getting a lot of gurgling/movement, especially after eating. Hoping things continue to settle down!

Hi Spooky,

I’m having the same symptoms 4 weeks post takedown. For the first 3 weeks all my complaints were centered around my butt (on empiric therapy for pouchitis which has helped) but for the past 4-5 days I have a ton of gurgling and buildup of gas under my stoma site. It actually bulges and gets a firm pocket of gas under it. Not to the point of being painful just uncomfortable like things aren’t moving though as the they should. I think it affects my appetite a bit. This all started after a few days of worsening straining that left my abdomen/old stoma site quite sore. Wonder if I screwed myself over and opened up the fascia a bit and now have an adhesion, or a hernia!

Like you I’m prone to adhesions and had numerous SBOs over the last 6 months while I had my loop. Two of them complete with concern for necrosis but was very lucky to avoid surgery. During my recent takedown my surgeon removed an adhesive band that had wrapped completely around the distal and proximal ends near the loop stoma.  Essentially strangulating the proximal bowel. He felt very satisfied that this was the cause of 6 months of hell. Of course now I wonder if I’m developing another adhesion in the same area :-(.
I’m very sorry you’re experiencing similar issues and I would love to read your updates and if things clear up for you. I don’t know if I could mentally survive any more obstructions, particularly recurrent.

Please keep us posted on your progress. All I can do is hope that our bowels find a more comfortable place to settle!

Hi Pouch2021,

Sorry to hear about all of your issues. It always seems to be something, doesn't it?

I have the same issue with being able to feel movement and sometimes a bulge near the stoma site. This has been the case for years. I have also been lucky to avoid any surgery to this stagw, but I can't help but wonder if luck won't catch up to me at some point. In 2014 I had 4-5 SBOs, all partial thankfully and only one needing a trip to the ER.

I will definitely keep you posted. I suspect my surgeon will take a wait and see approach as this is what we've done in the past.

I hope things improve for you!

Spooky,

Can I ask what your diet consists of? Have you been able to return to fresh fruits and veg despite the gurgling and bloating around the stoma? When I had the run of SBOs they were seemingly independent of my diet. I got one after drinking vitamin water following a fast for a procedure. I’ve woken with them despite dinner from the night before passing without issue. Leftovers caused on when the same meal the night before was fine. It’s maddening. Just seems these adhesions are unpredictable and I’m desperate at this point to return to a normal, healthy diet, or at least have hope that it’s possible.

Just a quick update; some of the COVID restrictions have been lifted and I'm getting in for a pouchoscopy next week, as my surgeon would like to take a look to see if it sheds any light on what has been going on.  I still suspect SIBO vs pouchitis but we shall see.  It's been an interesting 6 weeks to be sure.

Pouch2021 -- my diet is mainly vegetarian though I occasionally eat salmon.  In the past my SBOs weren't necessarily food-specific either. I suspect this time a stir fry (fibrous veggies and mushrooms) was a contributing factor, but certainly not the underlying cause.

I had my pouchoscopy today. My surgeon went up as far as the stoma site, as this has been the area of concern. Turns out I had a narrow stricture (3mm) at the resection site which he dilated to 15 mm. He said he highly suspects this has been the primary cause of the symptoms I've been having and he believes this should begin to settle down the problem, although he did say I may require more than one dilation.  Will see how things go over the course of the next few weeks.  I am not at all surprised as I had a series of similar obstructions several years ago.  Other good news, my pouch reportedly looks "perfect."

Next up is the gynecology consult for the other issues. I'm definitely making up for not seeing a doctor all of 2020 LOL

Always a relief to get some answers! Hope you can get everything resolved soon.

Thanks for the update, Spooky. It’s food for thought if I continue to have the gurgling/bloating and certainly if I (please let me not jinx myself) develop an obstruction.

@Spooky I’m so glad that a *treatable* source of the trouble was found! You should be up to your old tricks in no time.