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7 replies

Severe Pain - Inflammation?

peteraudio7peteraudio7Member
Hi. I am a 24 year old male and I had a Jpouch takedown on October 31st. My eleventh surgery in 22 months. Since then I had pouch inflammation which was treated for three weeks with cipro and flagyl. I have been off for a week now and I have felt increased inflammation internally. Externally I have skin tags protruding from my anus and whenever I go I have to strain in order to evacuate the pouch. The pain is severe. And the tags are getting bigger. Also, my output smells worse than usual. No internal bleeding though. I don't want to stay stuck on chronic antibiotics. I was never officially diagnosed with pouchitis. What do you all believe it could be? I'm actively trying to get this under control before I head back to college. Thank you!
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Jan DollarJan DollarModerator, RN, retired
Three weeks of Cipro and Flagyl are pretty big guns for not having pouchitis confirmed. Have you had anal stricture ruled out? Another concern are these growing anal tags. Could this be perianal Crohn's? Hemmorhoids? You may also have a fissure going on, and that would explain your intense pain and even the straining. You could even have a fistula or sinus tract.

Sounds very uncomfortable and it seems you need some good diagnostics.

Jan Smiler
peteraudio7peteraudio7Member
Thank you both for your responses! The current GI doctor I am working with wants me to try VSL #3 for two weeks before getting back on antibiotics. I may not be able to last that long though before going back to my doctor and requesting him check my pouch out and maybe putting me back on antibiotics in the meantime. And Scott, I do agree that antibiotics are the least of my problems. I just have been on so many antibiotics in the last couple years and I really want to find a med-free way to exist with this pouch.
Scott FScott FMember
Peter-
It's obviously better to not need meds. OTOH, pay careful attention to the following choice (which you might or might not face):
1) "med-free way to exist with this pouch"
2) use of medications that enable *thriving* with this pouch

I chose #2, and don't think it's a close call. I scuba dive, practice and teach martial arts, and go to the gym a few times per week. I don't fear long flights or drives or subway trips, and I don't have to leave meetings for a bio-break. For me, at least, medications are a perfectly acceptable price for all that.

I do try to ensure that I'm only taking meds that I need to achieve all that.
Jan DollarJan DollarModerator, RN, retired
Anal fissures occur inside the anal canal, but generally before where the pouch would connect with the anus. The anal canal is where all the sensory nerves are located, hence all the pain you feel. Anal fissures can be easily missed by the examining doctor.

The main thing is to be more certain of what you are treating. Just becuse symptoms improve with antibiotics it does not mean it is pouchitis. When symptoms quickly return after a course of antibiotics, you schould be scoped to determine what is going on.

JanSmiler
peteraudio7peteraudio7Member
I went to the ER yesterday evening and was put back on cipro and flagyl for the time being. I also am getting a stool sample checked for C. Diff just in case. I have an appointment with my surgeon on the 18th and hopefully we can schedule at least a scope. I agree with both of you that I need some diagnosing. Would it be worthwhile if I'm scoped to also get a CAT scan?

I appreciate your perspectives! I'm new to this forum and I really like the people here.

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