partial obstruction, sibo, c diff ?...advice please

Have you taken your temp to see if you have a fever?

I had c-diff with my j-pouch. Continuous fever, run down feeling, and diarrhea. 

Swollen feeling and pain in rectum could be abscess which I also had.

no fever. I didn't have a fever with the c diff last time, though, until several weeks in. No pain in the rectum...just this swollen feeling like something is down there, just inside.  Are there other symptoms with an abcess?

Probably depends on where abscess is. Mine happened soon after colectomy, before take down.  It was also infected, which meant several months IV antibiotics. Hopefully not what you have, but you should contact your Dr.

I am not sure about that 1% recurrance. Used to be that they thought it was impossible to get C. diff without a colon. Boy were they wrong about that! Regardless, 1% or whatever, it is possible. And, yeah, bleeding is a sign (this is one reason it mimics UC). So, I think C. diff testing is appropriate with your history. It is a spore former, and those spores can lie dormant, just waiting for your resistance to be low.

 

You also may be having something else going on down there. The discomfort could just be spasms of the sphincters during healing, but could also be from an infection. Either way, anytime you are having new and concerning symptoms, you need to tell your doctor. Otherwise, he just assumes all is good.

 

Jan

So, I had a c-diff test added to my pre-surgery testing.  It came back negative today.  Good news. Really didn't want to have that again. However, the diarrhea, nauseousness, weakness, loss of appetite, and heartburn keep coming and going.  In addition, the feeling like something is going to "fall out" of my rectum or is between my cheeks comes and goes.  Not painful, just uncomfortable when walking etc. (I had my surgery 16 or 17 months ago for the J pouch creation - is it still possible something is still healing down there?) Never had that feeling before. I get somewhat better for a few days and then go downhill again with the previous symptoms plus foul smelling stools.  When I got my lab results, I asked to have an appointment with my surgeon.  My surgery is in a 1 1/2 weeks.  I already have an appointment set up to have my mother come and discuss the surgery with me 2 days prior to surgery (need a second ear for objective purposes).  When I tried to make an appointment next week, they told me my surgeon was triple booked and could I wait until the 23rd?  If I do that, then if he needs to do testing, etc. it moves my surgery back AGAIN. so they agreed to an appointment on the 17th, but wanted to cancel my consult on the 23rd then (my mother is coming from another state to attend this with me, so I said no. ).  Are all colorectal surgeons this busy that it is difficult to get seen when there is an issue?

Also, I am thinking of maybe making an appointment with my GI doc - maybe she will have some input about the symptoms. Thanks again for your input.  It seems things can really be a bit of a puzzle sometimes.

Also, how do they test for an abscess - is it a test or an exam? Thanks.

A deep abscess (that can't be reached by a gloved finger) is most commonly diagnosed with an imaging study such as a CT scan. 

 

Your symptoms sound to me like you might possibly have a prolapse, though that would most commonly be associated with straining to defecate. Are you straining even though you're pre-takedown? A prolapse can sometimes be diagnosed on physical exam, and sometimes requires defecography (an awkward study that takes x-rays while you poop). In any case, I'm glad you're getting in to see your surgeon. The good ones are very, very busy.

yeah, i had cdiff infection day after my takedown

Update:  So, I saw my surgeon last night.  My surgery is postponed...again. He wants to make certain that I don't have a missed diagnosis of Crohn's before getting a j pouch or that there is not a parasitic infection going on.  He said it could just be a virus, but he would rather be safe than sorry.  So, I saw my GI this morning and I am getting the whole workup tomorrow (endoscopy, ileoscopy, and proctoscopy).  I don't think there will be a part of me that isn't scoped (LOL) and I have some stool sample labs to do.  My GI and I spoke about the Promethius test and she ordered that.  However, my insurance does not pay.  Does anyone know much about the reliability of this test?  Is it worth it?

 

Last night was a hard night. I won't lie.  Heart complications delayed my surgery, then a root canal, and now this.  Just ready to be done with the medical rollercoaster and on to living life again.  I know you all can relate.  But I know that it is better to figure out what is going on than to live in ignorance.  And my surgeon is being cautious...which is good.  Just a little "pity pot" time before I pull my boot straps up and keep rollin'. Still here right?!  And everyone has their own cross to bear at some point in their lives...My colectomy has given me 1 1/2 more years with my kids and husband. So thankful.  Just will be glad when the rollercoaster dies down a bit.  Uneventful can be a good thing. 

 

Oh, and he said the tissue that was bulging down was just a hemorrhoid, diagnosed via exam.  That is good news.  Just not sure how I got a hemorrhoid considering I'm not hooked up yet...

Update: visual scopes did not show Crohn's disease. Awaiting biopsy results. Scope showed inflammation in the bottom of j pouch which GI doc thought was due to digital exam. Still waves of nausea and occasional abdominal cramping now.