Severe bleeding with pouchitis and cuffitis

It makes sense that the pregnant uterus is putting pressure on those lower blood vessels that would not ordinarily have it. Remember, hemorrhoids are definitely worse with advancing pregnancy, for the same reason. Once a blood vessel is distended, ruptured, and bleeding, if it does not seal on its own, cautery or ligation is the only option. Can't just let you bleed out!

The inflammation is another story. Hydrocortisone suppositories are pretty safe. Even prednisone is OK, but make sure to watch your blood pressure, blood sugar, etc. They'd be monitoring for toxemia and gestational diabetes anyway, but steroids can increase your risk. Obviously, Canasa would be the better choice, but if it does not work, you have to move to plan B if the inflammation is serious.

jan

Thank you for replying!

It must be the pressure making it all worse.

Its good to hear that the laser cautery makes sense to you Jan - I had never read about it here so it kind of freaked me out and it was a regular GI who did it not my surgeon so I was a bit uneasy. However, the bleeding has slowed but not enough (the cautery was only to stop the bleeding) and I am still getting bouts of large amounts of bleeding (but not quite as desperate). The GI said that the state of things in my pouch looked like it was very likely that I would continue to have bleeding problems at least while pregnant.

Because I cannot tolerate the other stuff (Canasa) I think I am going to try local hydrocortisone (cortifoam) and see if that slows the bleeding. I hope it does.

Thank you Jan for the tip to look out for toxemia and g.diabetes more so with steroids.

I can normally stay calm about it all but I am so worried about my baby because he is such a miracle one-off that I am desperate for him to be OK. I feel badly enough taking the antibiotics and the beta-blockers never mind adding steroids to the mix.

Jeanne, sorry to hear that things are so tough. I hope that you find a good non-surgical solution, it must be awful thinking down those lines again.

Clicky,

I forgot to tell you on was on prednisone (prob 40 mgs) for my last 2/3 months of both of my pregnancies. I also had issues at the end as I gained 50 lbs with both pregnancies and I am very small with a narrow pelvis and the pressure/possible pregnancy hormones aggravated my colitis (according to my old GI).

I have two VERY healthy children (now 16 and 19). My son (16) is 6'3 (his dad is tall). I had big babies at birth (9 lbs and 8 15) and I had two c-sections, which with somewhat active UC, I was more than happy about. Try not to worry if for any reason you need stronger meds to get things under control although I know it is so hard when you are having medical issues and you are worried about the baby.

They put me through torture during both of my pregnancies with false positive test results for downs, (2 amnios), my son's heart was supposedly not on the correct access or something along those lines, a thickened placenta and concern about adequate nutrition etc. They used to have to pull out the medical reference books at UCONN (not a good feeling) as they never saw any case like mine before. Best of luck to you.

Thank you Jeanne for your reassurance re steroids, and thankfully I shouldn't need anywhere near that much!

I have been having increase in BM (20-25 x a day), with blood and urgency. I was having alot of rectal pain and pressure, but that has gotten better. I am 7 months pregant. I was put on melsamine suppositories and flagy for 14 days. I am at day 9 and there hasnt been much change. I not sure how it will get better in the next five. Getting to the point were should live on the toliet. I went to ER here (small town) and the GP told me that they wouldnt precribe me hydrocortosine suppositories unless my life was at risk? I tried to explain that from what i have read, i believe i have cuffitis. I have had pouchitis before and this is different. Just wondering if they said something similar to you? I am not sure how this is safe for baby either, me having diarrhea 20+ times a day. I also havent gained any weight this week.

Darcy,
I am sorry for your pain. Just wanted to let you know I took oral prednisone and oral sulfasalazine throughout both of my pregnancies with no problems when I had active Uc. you need to be seen by your Gi. I agree the diarrhea is not good for your body and the pain is something your gi should be able to prescribe to help you heal.

Hi Darcy,

I used steroid suppositories while pregnant. My high risk OB said no problem after this issue. I was also on continual antibiotics and found augmentin worked best. All worked out just fine. I was ill and they had to take him at 37 weeks as he stopped growing and I was really struggling, but now he's a big bouncing baby !

Sounds like you need some more knowledgable doctors in this.

Congratulations Clicky on your healthy baby boy!!!