Pouch scope question

You can’t match a small intestine location to a spot on the abdomen, except for the very beginning and the very end. An adhesion, though, can sometimes be attached at a very specific spot on the abdominal wall, and that sometimes localizes a problem. It can attach to whatever segment of small intestine that it attaches to, but unless a surgeon observes how far along the intestine that spot happens to be it will remain a mystery.

A pouch scope can be extended some distance into the ileum, and if you had a stricture along that area the scope could see it. Adhesions, though, are generally not detectable from inside the gut, where the scope is.

@Scott F posted:

You can’t match a small intestine location to a spot on the abdomen, except for the very beginning and the very end. An adhesion, though, can sometimes be attached at a very specific spot on the abdominal wall, and that sometimes localizes a problem. It can attach to whatever segment of small intestine that it attaches to, but unless a surgeon observes how far along the intestine that spot happens to be it will remain a mystery.

A pouch scope can be extended some distance into the ileum, and if you had a stricture along that area the scope could see it. Adhesions, though, are generally not detectable from inside the gut, where the scope is.

Ah ok, i just wondered where the scope could reach in relation to the location of the pain, but i kind of knew it would ‘t be that easy!

Yes an adhesion is my working hypothesis, and the reasons for the scope were to rule out Crohn’s activity causing a narrowing, or even a narrowed section caused by an adhesion.

Neither came up on the scope, and ironically he said it was the best looking scope he has done for years.

He had a balloon dilation attached to the scope but didn’t need to use it.

He has told me to stick to a soft diet for a solid 2 weeks at least, because i was too quickly reverting back to solid food after a few days of the soft diet, and he said the intestine needs time to heal.

I will do this, but if i still experience problems i might suggest an endoscopy to reach the areas he couldn’t from below.

I’m aware it could be an adhesion somewhere and i have to just accept it, but i was also wondering if us Pouchers could suffer from lazy bowel syndrome or pseudo intestinal blockages?

Crazier things have happened to me!

If by “endoscopy” you mean a scope from the top (an EGD), that typically won’t get far enough down to see what you’re looking for. That gets as far as the duodenum, which still leaves a substantial length of small intestine, mainly jejunum, unexplored. Two common ways of exploring the entire small bowel are a small bowel imaging series (after a barium swallow) or a capsule endoscopy. The capsule is a bit nerve-wracking if you think there might be a narrowing, since the capsule can potentially get stuck behind a narrowing. If that happens you get an unscheduled visit to the OR.

Good luck with your pouchoscopy. I do not know too much about the other stuff you asked but I wanted to offer something about the blockage thing, I like to advertise that drinking water before, during, and after every meal will help in the prevention of blockages, that has helped me greatly. I think that might be a good tip for the future.

Let me know how everything goes, I hope it goes well.

@Scott F posted:

If by “endoscopy” you mean a scope from the top (an EGD), that typically won’t get far enough down to see what you’re looking for. That gets as far as the duodenum, which still leaves a substantial length of small intestine, mainly jejunum, unexplored. Two common ways of exploring the entire small bowel are a small bowel imaging series (after a barium swallow) or a capsule endoscopy. The capsule is a bit nerve-wracking if you think there might be a narrowing, since the capsule can potentially get stuck behind a narrowing. If that happens you get an unscheduled visit to the OR.

Ah ok that’s very interesting to know that there is still a large portion of small intestine that can’t be reached, he has mentioned the capsule endoscopy before but said he would never have me do it due to the risk of it getting stuck.

Maybe the barium swallow is something i should suggest to him instead.

I’m in a frustrating position of not being bad enough to warrant exploratory surgery to look for adhesions, but also i’m on a restricted diet which is a bit depressing after a while.

Another issue is that the surgeon said that he wouldn’t want to do any adhesion surgery laprascopically because there is too much risk of accidental perforation, so that they now perform open surgery for this, and i think i have still got PTSD from my J pouch surgeries, so the thought is terrifying.

I’ll see what he says about the barium swallow.

Thanks

@Former Member posted:

Good luck with your pouchoscopy. I do not know too much about the other stuff you asked but I wanted to offer something about the blockage thing, I like to advertise that drinking water before, during, and after every meal will help in the prevention of blockages, that has helped me greatly. I think that might be a good tip for the future.

Let me know how everything goes, I hope it goes well.

Yes i do drink water alot more now, i can control the blockages with diet but it’s really depressing being on a restricted diet, im hungry all the time!

I have already had the pouchoscopy, he couldn’t see any issues and the intestine and pouch looked great

Thanks

@RB15 posted:

Yes i do drink water alot more now, i can control the blockages with diet but it’s really depressing being on a restricted diet, im hungry all the time!

I have already had the pouchoscopy, he couldn’t see any issues and the intestine and pouch looked great

Thanks

Oh good! Glad to hear that!! Water and diet is key!!! Sorry about the restricted diet. The beauty about the human body is that it can adapt to anything, that is the main difference between us and trees- trees need a good environment to adapt and we do not because we can fully adapt to anything. I truly believe over time you will be able to adapt to the restricted diet even though it can be depressing. When I first went vegetarian, I was hungry all the time too, for months!!! But over time my body adjusted and adapted. I think the same will happen for you over time.

Regarding the pouchoscopy, that would not be the first time I have heard of something like that exactly. A lot of people on here have problems and when they get it checked out, no problems are found. Unfortunately those people are often accused of being liars by the doctor or medical team, I think that is awful. Trying out different doctors may be able to address what the problem actually is if you feel your needs are not being met. You are completely justified in your feelings.