I've had a j-pouch since 2000 and haven't really had many problems until recently. For the first few years after the surgery, I had what I assumed were blockages - usually after eating a mixed green salad (stemmy raw greens) or exercised and became very dehydrated after eating vegetarian nachos (cheese n chips binding). It happened rarely and after a day or two laying on a heating pad and drinking water things would start moving again. Very liquid at first then returning to normal.
After that I went many years without such an episode and was essentially problem free. (I know, yay me!)
Recently, I've been having the same episodes more frequently, like 8-10 times last year and twice this year. All of them seem to result from eating something suspect (roughage of some sort). The symptoms are the same - severe abdominal pain as my small intestine seems to clamp shut. Half the time I'll bring back up a fair amount of what i've consumed in the previous 12 hours. Each time the "blockage" seems to eventually clear and I have very liquid stools for a day or so (no pouch or rectal irritation but still abdominal tenderness), then it returns to normal. Only change since previously not having these symptoms is my myalgia and fatigue have increased and I'm taking some thyroid booster and cymbalta to help with those symptoms, plus I've put on more weight and am now about 100lbs overweight on a 5'11" large bone frame(could that be putting more pressure on the intestine?)
Once out of the blue about 6 months ago(not in connection with one of these "blockage" episodes) I passed blood during bm for about a day. Finally went back to GI doc and they scoped and saw a few ulcers in the pouch, but otherwise it looked great. Diagnosed pouchitis, prescribed anti- then pro- biotics and that was that.
I've had a few more of these "blockage" episodes and I feel convinced this is all happening upstream of the pouch. I tried to express this to my GI but he was busy the day I went in and I'm not sure his NP fully understood.
Anyway, I'm interested in opinions here. It really seems to me to be more "mechanical" in nature, possibly exacerbated by recent meds, weight gain, etc. It has always resolved itself after a day or two with no anti- or pro- biotic treatment. And it always seems to come after eating something with a higher "bind" potential (roughage, cheese/corn chips).
What say ye?
PS great site! and thanks for your comments!
