Yes, it's that time again for..... Beachboy's Diversion Proctitis update. It's been a year since my rectal stump became inflammed enough to commence bleeding. Resulting in my pooping out blood 5 times a day, experiencing anal cramps, and just being damn uncomfortable. Also had to wear a pad. Unamusing.
Let's recap: Everyone with a rectal stump will develop inflammation. 70% will have no symptoms. 30% (lucky me) will have bleeding, cramps, and the feeling of having to poop (tenesmus).
Why does it happen? Stool provides Free Chain Fatty Acids and other nutrients that maintain a healthy microbiome in the rectal area. Since stool is diverted to a stoma, the rectal stump is deprived of what it needs to remain healthy, and inflammation eventually develops. The cure: Reversal or Barbie Butt surgery.
Treatments include Mesalamine suppositories, steroids, Butyrate enemas... and others. But, they have varying levels of success. Eventually medications become ineffective. In my case, Mesalamine suppository worked very well.... for 8 months. Then symptoms returned with a vengeance. I stopped medication.. and symptoms completely stopped. Buuuuut.... slowly over 3 weeks... symptoms returned.
And that's where I'm at now. Back to wearing a pad. Sucks. My Gastroenterologist gave me a rectal examination. Result: Inflammation. Duh!! But he had no ideas about treatment.