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Just looking for some thoughts.

I had a pouchoscopy about 2 months ago that basically showed the pouch looking very good, no significant inflammation, no pouchitis, etc. The GI thought things looked great and said I probably wouldn't need another scope for 2-3 years.

Despite that, in the past month or so I've gone on to have maybe 4 instances of bloody stool--or at least what I think is bloody stool. I've had red or dark red stool, definitely appears to be blood and looks like what I had with UC. I have had bleeding before, but it's not usually mixed in with the stool, more on the TP when I wipe. Also, the odd thing is that it seems to occur more toward the end of the day, and in between, the stool looks perfectly normal with no evidence of any blood. And I can go days and days where things are fine, then suddenly, out of the blue, another bloody stool. I have also had NO other symptoms whatsoever. No abdominal pain, no diarrhea, no urgency, no change in frequency. Okay, perhaps I've had a little more gas/gurgling than usual, but I've always had a lot of noise through the old stoma site so I'm not sure if that means anything. This is DEFINITELY not anything I've been eating. I've been quite diligent in that department. Basically, if not for the blood I'd say my pouch is functioning fanastically.

So, I'm going back to see my GI on Tuesday.

Just wondering if anybody had any thoughts on what this could be. Considering my scope looked great I'm not sure he'll want to do another one. Maybe a stool culture? I was on antibiotics about 4 months ago for a chest infection. I did not react well to those, and in fact I would trace these transient issues back to about the time I was on the meds. So, that leaves me wondering, would it be possible to have C.Diff without major symptoms?

I've been lucky to really not have had any major issues with the pouch thus far, so I'm a little baffled by all of this, especially since the issue seems so transient and everything else seems fine.

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Thanks for the replies. I agree liz11; C.Dff definitely needs to be ruled out. A stool culture would be the wisest place to start. I just wonder, if it is C.Dff would I not be having more symptoms?

Pouchomarx, yes, this is really an "all or nothing" situation, which is what I find most curious. It's puzzling to me that I can have what appears to be a completely bloody BM, and then absolutely nothing a couple of hours later. A fissure or hemorrhoid are definitely things to rule out, but I would think if I had either, that the bleeding would be more consistent. Actually, I would suspect cuffitis if I hadn't just had the scope so recently. I suppose that still could be the case; my UC basically flared up overnight so I suppose theoretically cuffitis could too. I guess I'll find out shortly.

chasingtime, yes, it's true that this has seemed to have happened more frequently since having the scope done, but I really doubt the scope had anything to do with it. This is not the first time I've had these symptoms (I had something similar happen once a few months ago, shortly after I stopped the antibiotics. However, since it was a completely isolated incident, I wasn't really concerned until I started getting the current sympotms). As far as the scope goes, I really think the timing is just a coincidence.

Anyway, if there is anything to report I will do so, though of course I'm not looking forward to any of this!
Spooky
I am thinking there is some sort of lesion that is beyond the pouch and out of view from the scope. Maybe there isa strictured area that has an ulcer. These can periodically bleed, and quite briskly too. Could even be an upper GI ulcer, but I'd think you'd have associated symptoms.

Perhaps a GI series might reveal something.

I had bleeding with cuffitis, but it was pretty minor, and I had pouchitis symptoms with it.

Jan Smiler
Jan Dollar
Thanks. A stricture or ulcer has occurred to me. I can always feel food/stool passing through the old stoma site, and it does make a lot of noise, so I wonder if the area is strictured. I know I am an adhesion former since my surgeon needed extra time to free up some adhesions when I had my pouch formation.

If it is a stricture or ulcer, what is the treatment? I'm hoping it's not surgery.
Spooky
Yup, gotta love docs. SO frustrating, especially since I was all psyched up to go, not to mention I had moved some work stuff around to accommodate the appointment. Now I'm just going to be waiting by the phone Monday (well, figuratively speaking of course, since the phone is always in my pocket *LOL*) until they can get me my new appointment.

You'd think we'd all be used to this sort of thing by now but this never ceases to be annoying or distressing. Thanks for the kind words! Smiler
Spooky
I FINALLY got a new follow up appointment and I'm now going on the 27th. Apparently the GI had a family emergency and was out of the country all week.

Interestingly, I have not had another incident of bloody stool since the day I called, which was now over a week and a half ago, but obviously whatever is going on seems to be an intermittent problem, and it's definitely something I still want checked out.
Spooky
I was sure that you knew how that worked... You get blood in your stool, freak out a bit, call the doctor for an immediate appointment because you're bleeding to death, and as soon as the appointment is made the bleeding stops. One more little game our special plumbing plays on us!

I'm so glad you have an appointment so that you can go in and find out everything is just fine.

kathy Big Grin
kathy smith
LOL Don't I know it! I've long since accepted that there may always be an issue or two lurking with our "special plumbing." Obviously, I've learned not to panic at the first sight of blood. The difference this time, though, it that it had happened 4 or 5 times in the course of a month, and it's darker blood, which definitely isn't the norm for me. So I figured, better safe than sorry. Mostly I'm just annoyed. Back to the GI again and the stinking hospital... good times! Smiler
Spooky
Mini-update on this...

So I saw my GI. He called my symptoms "somewhat unusual" particularly because they are so intermittent, and because I am having absolutely no other associated problems. He has ruled out cuffitis and pouchitis, and he doesn't think it's c.diff because the symptoms are too transient. Since I have not had any recurrence in 3 weeks, he doesn't want to do anything invasive now. But wants me to keep a record of anything that happens in the next 3-4 weeks and then call him with the report. If the problem persists then he'll send me for a CT or MRI for starters and go from there.

So that's that. I'm keeping my fingers crossed that it was just one of those random weird things.
Spooky

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