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I hope someone can help me with some info.  I have had my Jpouch for almost 3 years. I won't go into my whole journey.  4 months ago, my BMs changed; seemed "hung up" behind the old ostomy and umbilical area and after cramping and pain, some stool would do ally burst through.  I spoke to my surgeon who only scoped my pouch which showed SIBO and was given a course of Flagyl.(have had too many bouts of pouchitis over the last year). I told him then and emailed him many times with the same story that the issue for me is above the pouch. He dismissed my comments.  My distention and much worse pain for the last 2 months has reached a whole new level. The pain is excruciating mid belly.

I had CT enterography done by my GI 3 days ago.   I have a stricture and thickening exactly where I keep telling my surgeon about and a second "distention" in the same area.  My symptoms tell me that I am getting much worse. I put myself on a mostly liquid and some soft food diet as so little is getting through. I am nauseated all the time and GI who just did gastroscopy 3 weeks ago said I had gastritis and duodenitis. She feels now that it is reactive from the stool staying backed up (stagnating and inflaming)for many many hours filling my entire small.bowel. she is going to talk to my surgeon as surgery seems indicated and I am more than anxious to get this done. I am even okay if things get complicated and I end up with an end ileostomy.  I need my health back and not have day after day of terrible pain. My dietary changes may help a little, but will not affect the structural/functional situation. If my surgeon will not address this, I will ask for a 2nd opinion.



Thoughts?

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4 months of unremitting partial obstruction seems like more than enough. Is there a good reason to stick with your current surgeon? That’s who did the work that had this result, and who dismissed your issue. Perhaps your GI can suggest a different one. You may not really need a colo-rectal surgeon, since neither the colon nor the rectum (nor the J-pouch) is involved. Good luck!

They may be able to go in via a scope and open up the strictured area. I had a stricturoplasty (surgery) done on an area above my pouch but the stricture ended up returning (maybe b/c my UC diagnosis turned out to be Crohn’s?). I had multiple scopes done after that to open (and then re-open) the strictured area. Ironically, my stricture caused minimal symptoms for me personally but it was definitely a cause of concern for a number of GI people that I have seen along the way. Hope you can get some relief sooner rather than later!!

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