Stumped

ATXGuyMember

On Thursday, I started to get what research here has told me are the classic symptoms of pouchitis:

Increased urgency, increased frequency, watery stool, rectal pain, rectal pressure & a worsening of previously very mild butt burn. I also had a low grade fever (between 99.2 & 99.9 over the course of Thurs/Fri.

It worsened on Friday, and in desperation, I took a single Imodium after work, hoping to slow things down.

It seemed to do the trick; I didn't have a bowel movement between midnight and 5 am, and consistency was thicker when I did go. Today, I took another Imodium at about 10 am, and frequency/urgency/consistency have been in line with my post takedown experience, temp is normal, butt burn is back under control, gas is managed (beano before breakfast).

But the anal pain/pressure is still an issue. There is less pressure today (it comes and goes), but my the pain around my rectum/sphincter is still raging.

Based on my reading here, it seems that Imodium doesn't help with pouchitis frequency/urgency/consistency.

I don't think this warrants a call to the surgical group's on-call doc, but if it continues, I'll certainly call on Monday.

But I'm stumped. Is this pouchitis? If not, what is causing this rectal pain? I'm reluctant to take any NASIDs, but Friday was very much a UC flashback day and my butt HURTS.

12/20/148:41 PM

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Jan DollarModerator, RN, retired

Sounds like pouchitis, but this early it could easily just be an adaptation setback. Yeah, avoid NSAIDs. That would be counterproductive. If it is pouchitis, Pepto Bismol might help turn it around. Caplets are fine, you don't need to take the liquid. Of course, eliminate any foods you think might be irritating.

Jan

12/21/1412:34 AM

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skn69Member

Keep in mind but this is gastro season...so be on the alert for high fevers, full body aches and pains as well as all of the other symptoms.
You could be nursing the begining of a flu or gastro or both...or just a pre-christmas season indigestion.
I have learned the hard way that everything is not always pouch related...
Whatever it is the rules a similar in the begining...load up on those fluids, avoid irritants, keep to a bland diet (tea, bananas, applesauce, toast, rice...) and get tons of rest. Don't let yourself dehydrate, especially now.
Stay safe and warm too.
Sharon

12/21/1411:56 AM

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ATXGuyMember

Thanks Jan and Sharon,

I don't understand why Imodium would help if this is Pouchitis? I'm going to grab some Pepto caplets today and see if they help at all.

Overnight, was up a couple of times, which isn't "usual" for me these last few weeks (it's mostly been once or not at all), but the pressure is really active right now, though the pain isn't as bad.

This is really frustrating.

12/21/1412:32 PM

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Jan DollarModerator, RN, retired

For me, unless it is a particularly mild case, Imodium is worthless. But, that is me, not everyone.

Jan

12/21/1411:38 PM

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ATXGuyMember

Thanks again.

Still having the rectal pain & pressure, with some increased urgency & frequency, but stool is not watery, which could be Imodium related as it's effects seem to linger for a while with me.

Mostly though, it just flat hurts & I have a pretty high pain threshold.

Other than low energy and some increased fatigue, not really seeing much in the way of non-GI symptoms, no fever, etc.

Calling the doc in the morning, because I hope to get something working before the holiday really kicks in.

12/22/1412:53 AM

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Jan DollarModerator, RN, retired

Good idea. You don't want to mess around and wind up needing treatment over the holiday and having to seek ER care.

Good luck!

Jan

12/22/142:35 AM

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ATXGuyMember

Well, the doc basically said take Imodium as needed and call if I spike a fever over 100.

Things were better today with no Imodium, and pain was less, though still present. Fingers crossed.

12/23/142:03 AM

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ATXGuyMember

Well, the pressure & pain has continued, generally worsening over the course of the day until by bedtime it's pretty severe.

Saw the surgeon today after Bloodwork and a stool sample on Tuesday. Tests showed nothing, but a scope showed inflammation at the anastomosis, so he's put me on cortisone suppositories, one per day for a month.

Here's hoping this does the trick. For whatever reason, the last couple of days have been pretty great in terms of urgency/frequency, so if these knock out the rectal pain/pressure, I'll be pretty stoked.

1/3/151:34 AM

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shadoe-dMember

go get you some pro biotics to put the good flora back in your intestinal tract i use align or the walgreen brand of it works great normally

2/7/1511:31 AM

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