I have had two pouchoscopys in my first two years and will have them every year.  My surgeon did caution me about having one too soon after takedown, but he is also a proponent of them. My GI doc performs the prostate exam during the procedure as no one else is allowed up there.

I can’t speak to ur surgeons thinking, but I think you will find the consensus here to be very much in favor of them.

Have had annual pouchoscopies since 1992. Just had one on July 10. It looked better than the one we did in 2022, which was good news.

@MMOB posted:

a pouchoscopy, which is something that I've never had done before because my surgeon told me never to have one done. He didn't even want anyone doing a prostate exam.

This sounds completely nonsensical to me. Did your surgeon explain his reasoning? Did he explain that people with J Pouches sometimes get pouchitis and that the treatment for pouchitis is not "ignore it"? Did he explain that people who have J Pouches have colonic tissue in their J Pouch anatomy (rectal cuff) and it might be a good idea to check a remnant of your colon periodically, since the rest of it was removed presumably because it wasn't doing well? I am kind of at a loss for words. My surgeon told me to get annual scopes before I first got pouchitis (due to low grade dysplasia in my colon) and after I got pouchitis (due to both pouchitis and dysplasia). Nighttime incontinence is a hallmark symptom of pouchitis. I would suggest that if you and your surgeon ignore it, it's at your own very great risk.

Pouchoscopies are pretty routine and very low risk. The jury seems split on whether they are needed routinely on a well-functioning pouch without any history of colon cancer or dysplasia. I’ve chosen not to have them very often, and to let symptoms be my guide. Nighttime incontinence isn’t routine, of course. It’s probably pouchitis, and it’s probably prudent for your doctor to take a look before treating blindly.

There are also differing opinions about sedation for a pouchoscopy. I don’t bother, but plenty of people do.

Thanks everyone for your comments. I have one scheduled for Friday and I will go forward with it with a lot less trepidation now. Thx again.

Another thought.  Have you been checked for C-diff?  Good luck and please keep us posted.  I’ll pray for you.  

As requested, here's the update: The pouchoscopy went fine. The doctor found patchy erythema and superficial ulcers in the pouch c/w mild pouchitis. He also took a biopsy. He prescribed Xifaxan 550mg bid for 14 days, which I began taking last Friday evening. Although the biopsy results won't be back yet, I have a follow-up appointment scheduled with him for this Friday afternoon. Thanks again everyone for your comments, suggestions, and concerns.

Glad to hear that you have a handle on what is going on and are taking steps to treat it! The biopsies should be fine. I have had mild to moderate pouchitis for 28 years and it can be lived with, but going forward you should probably have annual scopes, until further notice.

@MMOB posted:

Hi, all.

I haven't been on the forum in quite some time as I had my J-Pouch in 2007 and things have been going as well as could be expected for the past 15 years or so. However, recently I've been experiencing nighttime incontinence and my new GI (I moved recently) wants to do a pouchoscopy, which is something that I've never had done before because my surgeon told me never to have one done. He didn't even want anyone doing a prostate exam.

My new GI thinks that is strange and says that pouchoscopy exams are routine and that he wants to do one before considering anything else such as prescribing antibiotics for pouchitis. He says that he would use a small endoscopy instrument. Even though he says there is nothing to worry about, I am quite sure that if and when I show up at the endoscopy center, I will still be asked to sign an acknowledgement form stating that something could go wrong and absolving the physician and the center of any liability.

My surgeon has long since retired and so I have come here to ask what your experience has been. After 15 years, I am sort of out of the loop as to what has been going on with relation to J pouches. Is a pouchoscopy procedure as routine as my new GI says it is? Am I really over-thinking this?

I appreciate any and all responses. Thank you.

I had my surgery around the same time as you (2006) and since then I have had a pouchoscopy every year. From what I've heard most docs try to wait 2 or 3 years between scopes, but that hasn't been my experience. Try not to worry, it's a good thing.

I appreciate your thoughts, but it is no longer a concern. I had my pouchoscopy a few weeks ago and everything went well. Thanks again.