Pouch Scope

The scope is no big deal, same as a sigmo, but dilation can be painful, so sedation seems very appropriate.

Jan

If they use the usual cocktail of demerol and versed then you will be in la la land, and slightly groggy after the procedure, so you need to have a friend/family member or SO drive you to and pick you up from the procedure. If they give you sedation you will be fine. In my case they have to penetrate way up past the pouch because I have inflammation in the ileum above the pouch and they need to check on and biopsy that area.

In my mind most younger IBD sufferers are spoiled as far as procedural pain. Back in the 1970s I had numerous unsedated colonoscopies and had no choice in the matter. You were compelled to suck it up. Now the IBD patient has a virtual candy store of pain relief options for scopes. One year I was even given the option of propofol (which killed Michael Jackson), or demerol and versed, or nothing. Nowadays, I always choose the demerol and versed cocktail. In my case they have to go up much higher and stretch it out so to speak. The propofol (which I took one year before the Jackson incident) completely knocks you out and when you come to you are not groggy.

I've had scopes done with and without sedation. They are pretty quick (like 10 minutes usually). Without sedation was very uncomfortable, but not painful by any means. When they offered me the Versed/Demerol combo last time, I chose to take it. I asked for a very low dose. As soon as they wheeled me back to recovery, I was wide awake and ready to go. I was not left feeling groggy. It was such a good experience that I will continue with that for my future scopes.

My first scope is in July. I'm planning on having versed and demerol, which worked great for colonoscopies. Since the dilation is very uncomfortable, particularly on the suture line, I'm not going to be a tough guy about it. I've been through enough uncomfortable procedures that I have no problem taking drugs whenever they're offered.

I'm glad to read this post. My first jpouch scope is next month - at least, I'm calling for a date next month, let's see if I get it. Relieved to read that I won't need to be awake for it. It's the one-year-post-takedown scope, and I don't have much to complain about, probably why I almost never post here.
Best to all.

A simple J-pouch scope generally doesn't call for sedation. It honestly shouldn't cause appreciable discomfort. Dilation or other complicating factors may change that.

Other factors most definitely can affect if it is painful. From the beginning of time, I was always told the scope exams should not be painful....all the way back to when I had UC.

Well, they hurt like crazy and I have only been sedated once before. That was 20 years ago while I had UC.

I am scheduled for a pouch and small intestine exam tomorrow. I have pain at the rectum due to continued irritation and a simple digital exam last week brought me to tears....and I can take a lot of pain.

I will be sedated and have no hestitation asking for it to be comfortable. There's no sense in being in pain.

I'm just saying all this to emphasize that "shouldn't" hurt doesn't fit for everyone. Don't be afraid to make your own judgement call on it.

Good luck!

I had a pouch scope last month without sedation. It wasn't bad and was over pretty quickly. It was slightly uncomfortable since you do have a tube with a camera going up your rear end. But it wasn't painful. And afterwards I was able to go on about my day since I wasn't groggy. Not sure if you would need sedation with dialation . I have never had that done. You will have to report back to us as to how everything goes .

I don't want to scare anyone with this story but I had a very bad scope done a while back in fact it is one reason why I'm
scared to finish with take down etc.

At the time I had a fistula in my belly that wouldn't go away. My main doctor that did my surgeries is in NY city and it's a real
pain for me to get in and out of there. So I asked if I could get it done at my local hospital. Doc said yes.

Before I went in I explained to everyone what they were dealing with. No sedation or anything. Well the first person
gave it a go and it hurt so bad I made them stop. They tried a couple of times, again I stopped them. This person
goes to get someone else "more experienced", she comes in, gives it a go. the scope went in a little bit, liquid went in, and all of a sudden I see stuff coming out of the fistula, I yelled stop. They did, I sat up and was in so much pain I almost couldn't get off the table.

While in the wheelchair I felt like I got beat with a bat. I told the doc and he just said take it easy, go home and if it doesn't go away call or come in. Easy for them to say.

I get home and by the time I got in the house into a bed I couldn't stop shaking. So much pain I can't even tell you.
We called my main city doctor, they called me in a bed and said get down here asap.

So, they ended up cutting me open again, they surgically fixed the fistula that kept me sick for months. While I was under they scoped me and found a tear in the stitching or something and fixed that too.

After all that my body finally started to repair itself. Fast forward, it's been a long time since then and I still need take down.
Health wise I'd like to put some more of my old weight back on but I'm back to riding my bicycle competitively so very happy I got that far.

I'm happy to read some of these storied, it makes me feel like when the time comes I know what to ask for and expect.

Thanks All

Alan Z

I am 7 years since my pouch installed, have had zero problems but have been scopped a number of times, It is easy, no pain at all. One doctor, a very good colon surgeon in California of Viet extractionh did once set me up for sedation but I told him I did not need it. His office staff told me "you very brave!" Othyer doctors told mke no pain meds or sedation needed and I agree. It takes only a few minutes and they only go in a few inches, little of the air pumpping that hurts with a colonoscope needed. If you have a day off and nothing to do, get sedated but if it costs you more or messes up your schedule, go without it.

Mark N, like you I am many years since JPouch installed (5 years) without any major problems. My surgeon used to just "scope" my pouch in his office - no prep other than fasting and an eneman, no sedation. It took a few minutes. But now that I am back under the care of my reg GI doc, he wants me to do full prep like back in my with-colon days. This seems wrong and I am very apprehensive...couldn't this cause problems? Isnt this unnecessary? Do you all have full preps before?

It probably would not cause problems. I did a full prep with magnesium citrate a few times. Got cleaned out really good, but it did not make for a better view for my GI. That is because there is bile and whatnot coming down all the time. I had one GI actually accuse me of not doing the prep! He didn't last long. But, for at least the past 10 years, the only prep I have is tap water enemas before I leave the house and clear liquids the day before.

Bottom line, it is unnecessary.

Jan

Thanks - that is what I thought. Wish me luck convincing my GI!

Often, it isn't even the doc issuing the instructions. He schedules a flexible sigmoidscopy and does not think to issue special prep instructions. Then the office assistant sends out the standard instructions. It can take some leg work to get a message back to the GI for clarification. That's why I LOVE email access to my docs....no middle man, lost in translation, yada yada...

Jan

In my case, I was with my GI in his office as I have just gone from surgeon's care back to my old GI who works at a diff hospital. He told me to book a scope with reception and I asked him about prep,etc. He insisted it will be full prep as it used to be. I explained that I hadnt had that in the 5 years of having scopes with surgeon. He would not even listen.

Oh my! Well, can't blame the staff then! Perhaps you can ask your surgeon to "enlighten" this fellow about the difference between an ileal pouch and a colon! Or, you may ask him if he requires this prep for an ileostomy scoping, since it is essentially the same organ.

Even when my docs were still prescribing the purging prep, they would tell me to take half a bottle or whatever cleaned me out.

Good luck!

Jan