I pretty much always have a rectal exam (just to check for rectocele) during my pelvics. It is no big deal unless your GYN has clubs for fingers. Try not to freak out about it. It is not as if you had your surgery yesterday. You are all healed up. Sometimes I think those surgeons cause more trouble than they think when they give such admonitions, especially when some of them can be pretty rough themselves. My GYN is very gentle. My GI always does a digital exam before a scope too, it is pretty standard.

Jan

Hi Jan! It just really surprised me. My GI uses his pinkie only and she used multiple fingers. Of course, my faith in her was not restored when she also asked me if I usually always had diarrhea(??!!)

I have always reminded my doc, "No rectal exam." right before she does the pelvic exam. It has worked for me.

Multiple fingers, really?! I've never had that, not for a rectal exam, just the bimanual vaginal exam. My GI uses his index finger, I think. My backside vision isn't the greatest, but that is what I feels like. That is how they dilate before inserting the scope.

I am not sure that stating you have a j-pouch would make any doctor alarmed and know that a rectal exam should not be done. It is not as if it is a bear trap in there. But, all kidding aside, I REALLY do not think you need to be concerned that some damage has been done.

Jan

My gyno is a petite woman with little hands. She always does a pelvic on me and she's aware I have a j pouch....she's careful and I trust her. I'm pretty sure she doesn't use multiple fingers though! Its actually pretty funny because she is fascinated by the whole j pouch thing! I wouldn't worry too much, I'm sure no damage was done.

Thanks everyone for your replies and support! It is wonderful to have someone who gets the whole jpouch thing as I don't personally know anyone who has this. I'm not as tender down there today but my cuff still feels a little bit swollen. I went ahead and put a call into my doctors nurse and would like his opinion.He has been my GI for fifteen years and also did my pouch surgery. He knows that I usually go with the flow (lol ) and take it in stride but I just want to be cautious with my precious pouch.

You can never go wrong with a little reassurance from your GI doc. That's what they make the big bucks for anyway!

Jan

I also always have a rectal exam and have since the beginning. I don't think any of my doctors ever said 'no rectal exams' so I've never been concerned about it.

kathy

Kathy....I wish my original colorectal surgeon hadn't mentioned rectal exams. He told me, "No one but him was to perform a rectal exam!". So, a year or so later, when I decided (for a number of reasons) I needed another colorectal surgeon, I actually felt "unfaithful" when I allowed my new colorectal surgeon to exam me rectally! Crazy, huh?

Was the divorce final before the new guy 'examined' you? If so, you weren't unfaithful. All is good.

kathy

a good measure in the future might be to have your gyn to call your crs or gi. have a little chat. I was told no one but a crs and nothing bigger than a pinkie finger. The measure of a good doctor is how much they listen and are attentive to your physical differences. I unfortunately have found most docs clueless about jpouches. It can't hurt them to call your doc and get educated. It only helps them become a better doctor.

Hi everyone. Just an update. Started with some deep aching across the top of my buttocks this past week. Visited my GI doc who wanted to know who the OB/GYN was and why she would do such an exam. He examined my cuff and anastomosis and said there was trauma done to the anastomosis and that I am developing a stricture there. He ordered four hot baths a day, lots of heating pad time, and a bottle of desitin, gloves, and to use a single finger to massage that sight a couple times a day. I guess this is kinda like a self dilation? as he gave it a good one in the office . He wants to see me back in the office in two weeks and he will scope my pouch then. He says the problem is not in the actual pouch but the anastomosis site because of the trauma to it. He said we are still ok at this point and that as long as I do these things, it should get better. I'm hoping so. He said the stricture is what is causing the pain. I have usually pretty good pain tolerance ( as all of us J-pouchers and UC survivors have had plenty of experience with pain!). Although it is frustrating, I did allow myself a private little cry in the car ride after my appointment. But a few hours later, my husband and I were poking fun at me and my new unfun issue. Most of the jokes cannot be typed for public viewing (LOL!!). But he did mention that I should get a tattoo down there that said DO NOT on one but cheek and ENTER on the other (NOPE, not doing that ). You know... what can you do but cry a little and laugh as much as possible?!! (oh, and buy some wonderful bubble bath)

Oh gosh wow. So sorry that happened to you. You should make that Gyn doc aware of her wrongdoing. I'm always shocked...appalled at how many doctors have NO clue what this surgery entails. I can't believe how many times I have to explain after saying I have a j-pouch/ileoanal anastomosis "no I don't have a colostomy (I get that question a lot- firstly it'd be an ileostomy), or no I don't have any large intestine left, etc."

Sigh...thinking of you. Hope you get better soon.

Geez. What sort of exam did she do? I've had to have rectals for various reasons over the years since I got my pouch, and everyone was gentle, and would even use a smaller finger to be safer sometimes. It's not that you can NEVER have an exam (my surgeon does exams... I've had scopes... I've had dilations and EUAs), but they need to be gentle ones.

What I suspect is that you had a stricture developing and your GYN exam turned into a manual stricture dilation. Your symptoms sound very much like people who had forceful digital dilations without sedation. I sure can understand the pain, since there are oodles of sensory nerves in the anal canal.

Doing the self dilation should help keep the stricture from reforming, so that is a good thing. Hope all your treatments help.

I agree that your GYN should have stopped if she felt resistance. You probably needed dilation, but by your GI doc, nt her.

Jan

I just had an in office quickie manual dilation. Owie. But luckily things are doing pretty alright... Too bad my stinking fistula hasn't matured yet (I knew it'd take longer than a month). I know my CRS knows what he's doing, but man, his exams are wicked stuff.