Stricture

Hattie, they are normally not interchangeable terms. Here’s a diagram of the three kinds of strictures. An overly aggressive dilation of a pouch-anal stricture might damage the sphincter, so it’s worth selecting an experienced and careful doctor.

I have been strictured at the J Pouch inlet for 10 or more years. It's very common to be strictured  in that area due to inflammation from backsplash stool. My GI doc said as long as he can get a scope through the inlet, there is no need for dilation. He will only dilate me if he can't get the scope through. He told me dilation is risky because there is possible stretching, tearing and bleeding and he doesn't want to do it unless he has to do it.

It's way more dangerous to do in the anal sphincter area, because once you stretch the sphincter you weaken it and threaten continence integrity. It's been suggested to me when I had a skin tag in that area that you don't want anyone other than a colorectal surgeon doing any procedure that could weaken the anal sphincter muscle. I got that opinion from multiple doctors.

I don't understand your use of the term "tightening" things- with a stricture things are TOO tight and stool isn't passing through freely. It's the intestinal equivalent of a clogged pipe. You want a free flow, not a tightened flow. Your anal sphincter is the muscle that contracts and controls fecal continence, but once its stretched out, the muscle is weakened. It's not a question of tightness or looseness, it's a question of how strong or weak that muscle is after any dilation procedure.

I do not have any experiences with strictures of the J-pouch, but I would highly recommend talking to your gastro about those important questions.

When you are talking about leakage, are you talking about leakage in the J-pouch sites like the anastomosis site or leakage out of the anus??? If you are talking about leakage out of the anus then that this not something I would be as worried about as having strictures. Strictures can be pretty serious, leakage out of the anus can be worrisome but not as bad as strictures are.

I would go ahead and get the dialations done with doctor/surgeon and if there is more leakage out of the anus, I am sure they are things that can help it, diapers for example. I wore diapers my early days of takedown and they are pretty helpful. I am sure everything will be fine.  

Hattie, I have an anal stricture. My colorectal surgeon did my dilation. I don't have problems with leakage though I have heard it can happen. I have to do self dilation from time to time to keep the stricture opened. I guess my advice for you would be to make sure that you have an experienced professional do the dilation. I definitely prefer my colorectal surgeon that did my surgery. My G.I. tried to do the dilation first, and that just didn't work out. Good luck. Let us know how everything goes.

Aimee