Small bowel series

Solomin,

I am not an expert, but your symptoms do not sound like pouch dysfunction to me, however if I recall you mentioned your pouch is misshaped at this time and I understand you have been suffering.

You would need a pouchoscopy with biopsies, a pouchogram test and an MRI/CT scan with and without contrast to really rule out pouch dysfunction that requires pouch advancement surgery. Blood tests would be helpful also. I have just had all but the pouchogram for my recommended pouch advancement surgery. They may also want to test your resting/holding anal pressure before this surgery is done.

Who is recommending this surgery and based upon what findings? If someone is telling you your small bowel series is fine and that you need pouch advancement surgery, I can understand your confusion. Did they look at your jpouch in this series as normally this is viewed when doing a pouchoscopy and via the CT/MRI scans.

I hope you can find a good, qualified gastro and surgeon who can help you work through these issues before signing up for additional surgery.

Hi Jeane,

My file has been reviewed (in person) by 6 surgeons and one academic doctor who specializes in jpouch issues.

All have said that I am in need ot jpouch reconstruction surgery.

I did have a CT scan (two within the last 6 months) and outside of inflamatory stranding (whatever that means) they have been normal (i.e. no bloackage present).

I keep on having what appears ot be partial obstructions on a fairly regular basis.

I have a complete history of several tests which show the shape of my pouch to be out of whack.

I recently had a flex sig test (similar to a colonoscopy) and my pouch looks good (no inflammation) and appears to be slightly dialated.

This entire situation has me quite confused. The worst part is the ongoing constipation and nausea, which at times is quite debilitating. I did have an endoscopy 3 months ago and all was clear.

So, at this point I really do not know what to think.

Thanks,

Solomin

My concern is that there is an undiagnosed upper GI condition that would not be addressed by pouch reconstruction. I can see going forward with the surgery to improve pouch function, because your pouch shape could be causing constipation symptoms. But, if your pouch shape was the source of your upper GI symptoms, you'd have a lot of distended small bowel near your pouch from chronic stasis and a backing up of stool.

Maybe there is a motility disorder, or Crohn's that could not be detected on the small bowel series. Maybe it is just IBS.

If you are OK with undergoing the surgery with the understanding you still may have the upper GI symptoms, it seems reasonable. But, if those symptoms are your primary driving incentive, I would want to get to the bottom of those first.

Just my 2 cents.

Jan