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New Sense of Urgency

These last few weeks have been stressful. I am teaching a summer class for new teachers in our district. I am getting my second cataract surgery done in a few days.

On top of it all, my father has been dealing with some medical issues, which has been putting an emotional strain on my family. So of course with the increased stress, I noticed a change in my bowel habits when it comes to my Crohn’s.

Increased urgency in my j-pouch with stress

It came suddenly. I am noticing that I have increased urgency, which does not necessarily mean I have to go to the bathroom. 

What do I mean by urgency? These are spasms that occur in my j-pouch. I can feel them, and it comes on every few minutes. Usually, they are not intense and I can deal with them by using the restroom when I get to one. 

Are spams in the j-pouch a result of pouchitis?

These days the spasms have been very intense and frequent. I started to think that maybe I had a case of pouchitis. Pouchitis is inflammation inside the fake colon called a j-pouch. This can be caused by the food we eat, that might cause bacteria to grow within the walls of the j-pouch.

Many people with the pouch get this from time to time, and it is usually treated with oral antibiotics. I am one of the rare IBD patients that have “chronic pouchitis...” I am on a daily dose of antibiotics and a probiotic to lessen the chance of it coming back.

Every once in a while, I get a bout of it and I just up the amount of antibiotics I take. Within a day or so, the symptoms subside. This week, however, my current condition has not gotten better. I am starting to worry.

Worries about increased bowel frequency and urgency

The increase in bowel frequency and urgency make me think that something is up in the pouch. I don’t think the pouch is failing. If that was the case, I would not be able to hold food down. I do however believe I have a stricture inside the pouch. This is a narrowing of the pouch entrance and exits. 

What causes strictures in a j-pouch?

Usually, it is caused by scar tissue from surgeries. The way to fix this is for the gastroenterologist to conduct a sigmoidoscope. Under the scope, he will be able to stretch the opening back to its normal size, so that stool can past through easier. As a result, the urgency would go away.

Next steps to figure out what is wrong with my j-pouch

Boy, I sound like a doctor, don’t I? This is my guess because it has happened to me before. Knowing my doctor though, he will make me get a stool study to rule out c-diff or any other stool infection. If my condition does not get better, he will tell me to get a scope down to explore what is going on in the pouch.

Am I nervous? Yes, because I have been doing so well for so long. Do I trust my doctor? Of course! I just am not in the mood to go through all these tests. I know I have to so I can feel better. Sometimes, we hit roadblocks with this disease. We just got to figure out how to maneuver around them.

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