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Last week I posted about a swollen spot that I suspected was hemmhroid or something more serious. The swollen spot has disappeared so obviously a hemmhroid. I did see GI for DRE and was also scheduled for flex syg. I have a flex syg tomorrow and have had overwhelming anxiety over it. Not due to actual test but due to what could be found. I have had jpouch for 9 years (UC) though have not been diligent with flex Sygs. In March of 2012 I had a perforation that required emergency surgery. The colorectal surgeon said the pouch looked great (exact word was pristine). The perforation was caused by twisting. Over the past 9 years I have had frequency, urgency and loose stools. Not uncommon and Not necessarily enough to warrant medical intervention.
Last August I had a capsule endoscopy and it looked great, no visible issues.
My concern is the threads about rectal cuff cancer. I guess I didn't realize that this could be an issue and to be honest I can't seem to determine the likelihood or risk. I know my anxiety is self induced (Internet research for silly cat videos = good, Internet research for medical information = bad).
Any words of wisdom? I am driving myself crazy with anxiety.
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I would imagine the risk will always remain, but with most of the large bowel/rectum removed, the odds are still in your favor that something else will likely be the cause of your demise rather than anal cancer.

Here's what a 2008 article stated:

"The risk of dysplasia following IPAA is small; so far there have been about 20 reports of cancer developing in the pouch or residual anorectal mucosa, and in virtually all of these patients dysplasia or cancer was present at the time of IPAA (4). The risk is increased in patients with chronic pouchitis and primary sclerosing cholangitis. There are no national guidelines for surveillance; we recommend that surveillance flexible pouchoscopy should be undertaken every three years in patients with UC of more than 10 years duration. In those with previous dysplasia annual surveillance is recommended."

www.practicalgastro.com/pdf/Au...cLaughlinArticle.pdf
It doesn't sound like the anxiety has much to do with the actual pouchoscopy (it's not really a sigmoidoscopy, since you have no sigmoid colon, but that's the instrument and the closest available billing code). Driving to the procedure is likely to be riskier than the procedure itself or the risk of rectal cuff cancer. In any case, you might want to start thinking of the anxiety as a problem all its own, worthy of attention and treatment. Just a thought.

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