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PSC & losing the j-pouch

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Hi all,

I just had a hepatologist tell me that people with PSC have an 80% chance of

losing the j-pouch, so the j-pouch isn't recommended if you have PSC. This

was a shock to say the least. Has anyone here lost their j-pouch? The

alternative of an ileostomy seems pretty grim to me. I have heard that with

persistent pouchitis, you can lose the j-pouch.

-Marie

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Marie, I had a dx of PSC when they found dysplasia in

my colon after 16 years of UC. I went to the

Cleveland Clinic for evaluation and possible removal

of my colon.

It was at Cleveland Clinic that Dr. Fazio told me that

J pouch WAS the way to go with a dx of PSC.

I had my Jpouch surgery December 1999 with take down

3-2000. Up until 1 month ago....I had never had any

problems with my pouch. Now, I seem to have an

extreme urgency problem that stops me dead in my

tracks until the urge subsides...otherwise I leak. I

am thinking that something in my diet or my meds is

causing it, so I am going the route of elimination of

items to see what happens.

I had been a huge succes with jpouch because only

after 6 weeks with it, I was down to 3 trips in a 24

hour period.

I would definitely get second opinions on having the

jpouch removed. Cipro can help with pouchitis. Don't

just take one doctors viewpoint. The 3 months with my

ileostomy were the worst 3 months of my life. I

didn't like any part of it. I know there are some who

have no problems, and my problem could be the

ileostomy was up high in preparation of the jpouch,

which may have caused much more caustic products

leading to alot of problems.

Cindy Baudoux-Northrup

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Hi,

My husband would love to lose his J-pouch as it has never worked

right for him. He received it in 2002. Doctor Remzi and Dr. Zein at

Cleveland Clinic told him that with PSC the pouch is going to have

problems, ie. persistent pouchitis. He was on Cipro...didn't work,

he is now on Xifaxin which might be working but the day he stops

taking an antibiotic is the day his pouchitis really flares up along

with cholangitis attacks.

He had three ostomies while constructing his J-pouch since the first

surgeon screwed it up. Dr. Remzi at Cleveland Clinic fixed the pouch

so at least surgery was successful but his quality of life was much

better with the ostomy than the pouch. They won't reverse the pouch

since he is on the transplant list because they try to avoid all

surgeries if possible prior to transplant.

He has had persistent pouchitis for 5 years and never a mention of

losing it.

Kathy

>

>

>

>

>

> Hi all,

>

> I just had a hepatologist tell me that people with PSC have an 80%

chance of

> losing the j-pouch, so the j-pouch isn't recommended if you have

PSC. This

> was a shock to say the least. Has anyone here lost their j-pouch?

The

> alternative of an ileostomy seems pretty grim to me. I have heard

that with

> persistent pouchitis, you can lose the j-pouch.

>

> -Marie

>

> _________________________________________________________________

> i'm making a difference. Make every IM count for the cause of your

choice.

> Join Now. http://im.live.com/messenger/im/home/?source=TAGHM

>

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Cindy,

I have a feeling the source of this info wasn't so good. I don't recall

hearing that people with PSC tend to lose the j-pouch. Mine is doing okay.

I'm on flagyl for the pouchitis, and probiotics. I should probably be on

more flagyl (I'm only taking 250 mg twice per day. The normal dose is 500 mg

at least twice a day. I had the ileostomy for 3 months as well, and it was

the pits. So I plan to keep the j-pouch.

-Marie

>

>Reply-To:

>To:

>Subject: Re: PSC & losing the j-pouch

>Date: Sun, 7 Oct 2007 14:50:40 -0700 (PDT)

>

>

>Marie, I had a dx of PSC when they found dysplasia in

>my colon after 16 years of UC. I went to the

>Cleveland Clinic for evaluation and possible removal

>of my colon.

>

>It was at Cleveland Clinic that Dr. Fazio told me that

>J pouch WAS the way to go with a dx of PSC.

>

>I had my Jpouch surgery December 1999 with take down

>3-2000. Up until 1 month ago....I had never had any

>problems with my pouch. Now, I seem to have an

>extreme urgency problem that stops me dead in my

>tracks until the urge subsides...otherwise I leak. I

>am thinking that something in my diet or my meds is

>causing it, so I am going the route of elimination of

>items to see what happens.

>

>I had been a huge succes with jpouch because only

>after 6 weeks with it, I was down to 3 trips in a 24

>hour period.

>

>I would definitely get second opinions on having the

>jpouch removed. Cipro can help with pouchitis. Don't

>just take one doctors viewpoint. The 3 months with my

>ileostomy were the worst 3 months of my life. I

>didn't like any part of it. I know there are some who

>have no problems, and my problem could be the

>ileostomy was up high in preparation of the jpouch,

>which may have caused much more caustic products

>leading to alot of problems.

>

>

>

>Cindy Baudoux-Northrup

>

>

>

>_______________________________________________________________________________\

_____

>Take the Internet to Go: Yahoo!Go puts the Internet in your pocket: mail,

>news, photos & more.

>http://mobile.yahoo.com/go?refer=1GNXIC

_________________________________________________________________

i'm making a difference. Make every IM count for the cause of your choice.

Join Now. http://im.live.com/messenger/im/home/?source=TAGHM

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Share on other sites

's pouch is doing fine. Some days he " goes " more than others, but

a lot of it is what he eats. We found that older doctors tend to shy

away from the J pouch. His GI wanted him to have an ostomy, but the

general surgeon he sent us to, really felt that at 's age (27 at

the time) he should at least try to have the j pouch done, so he

himself researched and found the best colorectal surgeon in our area.

We have great respect for the general surgeon for turning down a

surgery in order to do what was best for . The three months

between surgeries was awful for . He was so depressed with the

ostomy and is greatful for his j pouch. We were told that he would

have more frequent bathroom visits due to the liver disease. Something

about the bile. Thankfully, things appear to be much better since

transplant. In his case, he was using Lomotil and Imodium plus another

drug to try to reduce the bathroom visits. Since transplant, only

Lomotil. He was also using a full tube of Calmoseptine (ointment) a

week and now he uses about a tube every couple of months. I totally

think the new liver helped.

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Thank you for telling 's story and your impressions of older GIs.

I think the info the hepatologist got on 80% of PSCers losing the J-pouch is

incorrect.

-Marie

>

>Reply-To:

>To:

>Subject: Re: PSC & losing the j-pouch

>Date: Mon, 08 Oct 2007 02:43:51 -0000

>

>'s pouch is doing fine. Some days he " goes " more than others, but

>a lot of it is what he eats. We found that older doctors tend to shy

>away from the J pouch. His GI wanted him to have an ostomy, but the

>general surgeon he sent us to, really felt that at 's age (27 at

>the time) he should at least try to have the j pouch done, so he

>himself researched and found the best colorectal surgeon in our area.

>We have great respect for the general surgeon for turning down a

>surgery in order to do what was best for . The three months

>between surgeries was awful for . He was so depressed with the

>ostomy and is greatful for his j pouch. We were told that he would

>have more frequent bathroom visits due to the liver disease. Something

>about the bile. Thankfully, things appear to be much better since

>transplant. In his case, he was using Lomotil and Imodium plus another

>drug to try to reduce the bathroom visits. Since transplant, only

>Lomotil. He was also using a full tube of Calmoseptine (ointment) a

>week and now he uses about a tube every couple of months. I totally

>think the new liver helped.

>

>

>

_________________________________________________________________

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http://www.reallivemoms.com?ocid=TXT_TAGHM & loc=us

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