Pouchoscopies with Ulcerative Colitis: Are You Keeping Up?

by Jackie Zimmerman Patient Advocate

Before receiving my J-pouch, and even after, I really thought for a long time that words like “pouchitis” and “pouchoscopy” were totally made up. They are, however, actual words that describe actual conditions and procedures that people with J-pouches have. I’ve had a few dabbles in pouchitis, but pouchoscopies are something that I’ve let slide for the last few years.

What is a pouchoscopy?

Like every other part of the digestive tract, J-pouches need to be regularly checked and examined for problems, like inflammation and cancer. In my opinion, a pouchoscopy is a simpler process than traditional colonoscopies, and therefore more tolerable. In my experience with pouchoscopies, your gastroenterologist (GI) will take the same camera they would use for all other scopes and conduct this scope much like a flex sigmoid for those who still have their colons. The prep for a scope with a J-pouch is a total breeze! For me, I generally stop eating before midnight, and then I’m set to go for the next day when I’m having a scope. No more nightmare bowel preps! One of the perks to a J-pouch for sure.

The pouchoscopy is a very quick procedure, often lasting just a few minutes, and is strictly focused on examining the J-Pouch itself, which means that the scope only goes a few inches into your pouch. This means there is no real reason to use anesthesia, which also makes the whole process much quicker. You can be in and out on your lunch break! No, for real. I’ve done that.

How frequently should you get a pouchoscopy?

Most GIs and surgeons recommend getting pouchoscopies once a year, so long as you’re not experiencing any problems. Once a year can feel like a really short period of time if you’re feeling well, but the reality is that a lot can happen in your pouch. The sooner you find it, the better.

I haven’t exactly followed this yearly scope rule. In fact, I didn’t have a regular GI for a while and let my yearly scope extend to a scope every three years. Don’t be like me. You may remember that I recently got a new GI, and when she saw that I hadn’t been scoped in nearly three years, she decided it was time to check everything out. I begrudgingly agreed.

What are they looking for in a scope?

As someone with ulcerative colitis (UC), you’re always at a high risk of getting colon cancer. You can get cancer even in those 3 centimeters of rectum that are left in your body. Regular screenings can help make sure you are cancer free. Scopes of the pouch can also look for new inflammation, leaks, or other problems that may appear.

One of these problems may even be an old surgical staple that is still in your pouch and causing inflammation, which is what my GI found in my most recent scope. She said she felt it during my rectal exam but couldn’t figure out what it was until we did the scope. We both saw it on the screen clear as day. The irritation and inflammation it was causing was minimal, but we decided we definitely needed to keep an eye on it. I’ve had my pouch for 6 years, and this is something new, which is why it’s important to always get scoped regularly!

OK, truthfully, how bad is it?

Honestly? Pouchoscopies are a piece of cake. In fact, I had a nice conversation with my GI while she was doing mine, and when we found that staple, we talked about what to do about it while she was still conducting the scope. Sure, you will still feel the pressure of the air, but if you can stomach it, it’s actually a really cool experience to see your pouch up close on the TV screen. There should be no pain or discomfort unless you have inflammation or something else unusual going on.

Bottom line: go get your J-pouch scoped! Continue to keep up with regular annual scopes in order to prevent potential problems. The chattier you are with your GI, the more pleasant the experience is for both of you!

Jackie Zimmerman
Meet Our Writer
Jackie Zimmerman

Jackie Zimmerman is a multiple sclerosis and ulcerative colitis patient and the founder of Girls With Guts. Since diagnosis, she has blogged her IBD journey at Blood, Poop, and Tears. Jackie has worked hard to become a strong voice in the patient advocacy community. In her free time (what free time?!) she spends time with her two rescue pups, her husband Adam and plays roller derby. She’s online @JackieZimm.