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Warning-sign checks

Total proctocolectomy and ileal-anal pouch: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for severe breathing difficulty, chest pain, fainting, heavy bleeding, confusion, or other rapidly worsening symptoms.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact your surgical team promptly for increasing abdominal or pelvic pain, repeated vomiting, fever, worsening abdominal swelling, new wound redness or drainage, or difficulty keeping fluids down.

    If you have an ileostomy, seek prompt advice for no output with cramps or vomiting, suddenly very high watery output, marked thirst, reduced urination, dizziness, or unusual weakness.

    These may indicate blockage or dehydration.

  3. 3

    Does any of this apply?

    Book an appointment

    These can occur with pouch inflammation or another complication and are not simply part of routine adaptation.

    Questions about diet, expected stool frequency, mild skin irritation, supplies, return to work, or routine test results can usually wait for normal clinic hours.

The article also says

After pouch surgery, new frequent watery stools, urgency, bleeding, fever, or pelvic pain should be assessed.

Every sign above is quoted from the sofidex article on Total proctocolectomy and ileal-anal pouch. If you are not sure, err upward — it is always reasonable to be checked.