Well I have an answer. Not a hemorrhoid or a skin tag, but a Hypertrophied anal papillae. Totally benign.

My surgeon says normally he'd just snip it off, but I'm not an average patient and he doesn't want to risk infection close to the pouch, so we're going to leave it for now. Often they do reduce on their own, according to him, so we will leave it for now and just monitor. He did prescribe cortisone for week just to see if it helps, but otherwise nothing to do.

You learn something new every day, I guess.

Hi also have a skin tag.  I noticed it one year after my j-pouch surgery.  My surgeon told me just leave it alone.  Now it's been 8 years since surgery the skin tag is just a little larger but doesn't interfere with bowel movements.  When I have pouchitis it seems to get a little larger.  I am still not able to gain weight.  There are just certain foods that I just can not eat.  I spoke to nutritionist, she told me try other foods with baby steps.  I have been trying to do that but than I always have bleeding and burning at night.  I can't tolerate it any longer.  Does anyone have a magic solution for this problem?   Thanks   Grace

Hi Grace,

I have two external skin tags that don't bother me at all. The newer issue I have is the hypertrophied anal papilla, which - in terms of the most simple description - is basically an internal skin tag which has prolapsed and is now protruding through the anus with bowel movements and needs to be manually pushed back in.  It's not a hemorrhoid, however it does become irritated and sore. It's also not likely to shrink spontaneously from what I have been told. My surgeon is reluctant to remove it given the proximity to the pouch, but my guess is that if it continues to become irritated and/or gets larger it is probably going to have to be removed at some point.  It's an annoyance right now more than anything, and other than barrier creams there isn't much I can do for it. The hydrocortisone ointment did provide some relief, but cannot be used long term.

Just based on your post, it sounds like your issue is more related to pouchitis and weight gain rather than the skin tag.   Have you been tested for anything else such as Celiac, allergies, or c-diff which may be contributing to your issues/food intolerance? Has Crohns been ruled out? Short bowel syndrome? Medication side effect? I'm sure there could be many other avenues to be explored, and there are others on this forum who can perhaps suggest some other factors that should be ruled out well. I do know that weight gain in general can be tricky after surgery. My weight at one point was down to 85 pounds after my colon was removed, when I was severely ill with ileus. I was in hospital for a total of 5 weeks at that time. I had absolutely no appetite. When I was finally discharged, I started back by eating 5-6 very small meals a day, and I was advised (obviously) to ensure those meals were high in calories. Lots of peanut butter, cheese, protein, etc. Gradually I was able to eat larger meals.  It took me quite a while to gain my weight back as well as my normal appetite, but I did eventually gain with the help of a dietitian.  I wish you the best of luck in getting the answers you need!