JPouch and Proctitis in Rectal Stump

Hey guys,

I had a scope yesterday to check my pouch and the pouch looks great. However, I have some small fissures, a hemmy internally and my rectal stump apparently looks "angry" according to my doc and is bleeding/inflamed.

Question, has anyone with a JPouch had proctitis on their rectal stump that was left? If so, how'd you treat it? He gave me a hydrocortisone cream but it's tough to get there I think. Cortifoam may be a better solution I would think?

Thanks,
M

You mean on the cuff? I have been lucky, and no, but I had a mucusectomy, so maybe that helped. I always had terrible proctitis, so I expected to have the worst of the worst outcome, and I've been OK, so I do not know. I thought rectal stump is gone at the end and all that is left is a cuff? Please let us know what you know. I would suggest you request you records. You can read through and find out details. I got mine for insurance purposes, but they were very informative.

Yeah. I've had my take down (surgery 2 of 2). I'm just reciting what my doc said as he mentioned "Rectal stump" and proctitis. Could be the cuff, he's done not 1000's of JPouches but maybe like 200 or so? So I'd assume he knows what he's doing. He's not a fan of suppositories because of risk of tearing near the connection.

He prescribed a flagyl ointment I believe and a cortisone cream since it's just the first few 1-2"s. I've been using some cortifoam that I still had left from before. I guess I'll call him and ask for more details.

I'm pretty sure your surgeon meant rectal cuff, as that's the only part of your large intestine that remains at this point. It's a very small piece and necessary to not be incontent. It can become inflammed. The cuff is usually scraped good to remove the shallow surface that UC affects.

Anti-inflammatory canasa suppositories or steroid suppositories would be your go to. Topical creams might work as well.