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Cliffmegacolon
Hi All

I had my pouch creation and takedown back in 2005 and have had 7 good years since. Earlier this year I developed an anal stricture, which was dilated by a general surgeon in July. This dilation was unsuccessful and the stricture hasn’t improved.

I have just been back to see the general surgeon and he has advised that he doesn’t see any benefit in dilating the stricture again and is referring me back to the specialist surgeon who created my pouch 7 years ago. Apparently due to the severity of the stricture I may need surgery to fix it and this may involve a pouch revision.

This has left me a little worried as to the extent of surgery that would be required to fix the stricture and/or revise the pouch. If there is anybody out there who has had a similar procedure or is aware of what is involved I would love to hear from you, if only to ease my concerns.

I’m worried that this may involve open surgery requiring a lengthy absence from work and the need for a stoma again, both of these eventualities I would love to avoid.

Thanks for any information anyone can provide.

Kind regards

Clive

Replies sorted oldest to newest

P paulnMember
cliff, there is a surgical procedure known as strictureplasty which is done on an outpatient basis,my was done at weill cornell medical college ala ny presbyterian,i had my done and it has helped.This procedure is done to try to prevent multiple dialations as jeans has described,not pleasant but i believe it might help you.Cliff good luck and i hope you will feel better.pn
P
mgmt10mgmt10Member
Right after my takedown I had a stubborn anal stricture. I had to go a total of 6 times to my surgeon to have it dilated over the course of a year. It is finally staying open now. All 6 times they were done in his office. I never had to be put under or anything like that. Yours sounds like it may be more difficult than mine but it did take more than one time to nip it. Wish I had more info for you on this. Best wishes.
mgmt10
CliffmegacolonCliffmegacolonMember
Many thanks for the responses and advice. It’s reassuring to know that there is a procedure that can rectify this problem and hopefully it won’t require open surgery. The research I’ve done on the internet suggests that this kind of pouch advancement surgery is performed perianal (SP?) which I’m assuming means done through the anus?

I’m now just waiting for my consultation with the specialist, which unfortunately due to the slow pace of the UK national health service, it will probably be a couple of months until I have an appointment!!

Thanks

Clive
Cliffmegacolon
CliffmegacolonCliffmegacolonMember
Hi Leese
I haven’t had the surgery yet I’m still waiting for an appointment to see the surgeon. Unfortunately the cogs of the UK NHS turn at a very slow place so it could take up to 4 months to get an appointment!! I have private health insurance but they won’t cover any J-pouch related issues as they consider it a pre-existing condition!!
I hope you are feeling a little better and there has been some improvement since you posted. I’m interested to know did you get a temporary ostomy after the pouch advancement or do they plum you back in?
I have a persistent stricture and I’m not even sure if I’ll need a pouch revision but know its one possible surgical option.
Thanks
Clive
Cliffmegacolon
CliffmegacolonCliffmegacolonMember
Hi Jeff

Whilst I’m not adverse to self dilation (although I’ve never tried it), I’d rather wait till I’m advised to do so by a healthcare professional and given instructions on the proper procedure.

I had a dilation under general anaesthetic a couple of months ago which proved unsuccessful. The surgeon that carried this out said that the scar tissue that causes the stricture is formed from very hard and inflexible tissue, and that if you apply too much pressure when dilating, it can cause the tissue to crack and perforate the pouch!!

As it happens I got my appointment through the post yesterday and will be seeing the specialist pouch surgeon in early December, so hopefully we can find a solution to sort this stricture out, which may well be self-dilation.

Thanks for the advice

Clive
Cliffmegacolon

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