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Hi ladies,

So like many of you, I weighed the options carefully when I was pregnant and chose to go with a vaginal delivery. The delivery went well, I had to very small tears, I went totally natural and was up and felt great just minutes after delivery!

Unfortunately, with delivery has come night time incontinence...and often. I used to have night time incontinence once or twice a year. I can deal with that. Now it's a few times a week unless I'm on antibiotics.

I'm assuming that I have mild pouchitis (no bleeding or pain, just night time incontinence as a symptom) which is why the antibiotics help, but I don't want to be antibiotic dependent. My GI is useless. He says to just stay on antibiotics and to take Imodium. First of all, I'm breastfeeding and no stool hardeners are allowed. Secondly, I don't want to get to the point where I'm immune to antibiotics and finally, there are long term side effects of antibiotics and that's not much better than pouchitis in my opinion.

So what am I to do? I am on heavy duty probiotics which helps a bit. I know what foods trigger accidents but often incontinence will come no matter how well I eat. Doctors only seem to know about heavy duty drugs and Natural Paths know very little about j-pouches in general.

Anyone else experience this much night time incontinence and find a way to stop it? I've read the other discussions about night time incontinence and I've found that advice hasn't helped me.

I've tried:
- drinking lots of water at night
- cutting out dairy
- taking probiotics
- bee pollen (some say it helps treat UC, so I figured it couldn't hurt to help treat pouchitis)
- cutting out chocolate, deep fried food and caffeine

I'd also like to have more children. I'm leaning towards c-section because of this incontinence which is unfortunate because I had a very good, uncomplicated delivery.
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I came across your posting because I am currently pregnant and have been reading about c-section vs natural delivery. Your situation sounds miserable. I haven't had issues with incontinence and I've been very lucky with my pouch (15 years old now!), but I thought I might have some suggestions for you since no one else has replied.

Have you tried a fiber supplement? Bulking agents can help if you only have issues when you have liquid poops. They shouldn't affect the baby at all. I have a very minor fistula and adding some soluble fiber seems to help. I've heard people like the fiber biscuits too. Also, you probably don't have pouchitis just because the antibiotics work. Every time I take antibiotics I get the j pouch version of constipation (less frequency) which is nice but the other side effects aren't so nice (really bad intestinal cramping, increased risk of drug allergies ect). I am allergic to most of the major classes of antibiotics and have read all sorts of horror stories about c diff so I understand why you don't want to take antibiotics. They are terrible for you and are best to avoid if you don't have an infection!

Do you need to cut out dairy? If you and your baby don't have issues with it, it can help keep your pouch happy and slow things down. I love yogurt and cheese because they are low bulk and slow down my digestion. Be careful with probiotics if you have incontinence at night. I can't take most probiotics because they include sugars for the good bacteria but give me really bad gas, which can equal night time accidents.

Good luck and I hope it gets better!
Thank you for your reply LC. I do find that fibre does help a bit but it doesn't guarantee anything. I do use the All Bran bars.

I did take myself off of dairy simply because I want to figure out what help and what hinders this. I do still eat cheese and I have started making my own kefir which has helped me a lot thus far. I've only been taking it daily for about 2 weeks but have not had an accident since. I've been reading that a glass of kefir has 5 trillion probiotics, contains no unnatural sugar and the lactose (milk sugar) has been fermented and partially digested as the kefir ferments. I've looked online a bit and people say it has significantly improved chrones and colitis symptoms so hopefully it will tackle pouchitis symptoms too. I find that probiotics on their own do help a bit but they don't prevent pouchitis and they do cost a lot.

All the best with your pregnancy and delivery. It's a hard decision to make. You can't predict the future. Many of the studies I read didn't have any long term information regarding bowel control after natural delivery but said that up to 5 years of delivery women remained continent. I have no issues during the day and only issues at night when I get pouchitis. Would I go natural again? I think I will, for our next one seeing as unless I'm sick, I am continent but it's a tough, personal decision. I love how I had no recovery, felt great right after delivery and I just feel in my heart that natural is best for baby as well.

All the best, and thanks,
Lydia
I would try not drinking lots of water before bed. I try to limit my liquid intake and just sip water- I eat crackers if I am thirsty and drink too much water. Also, try more bulking food like rice and applesauce before bed. I make rice pudding almost very week, and have hour before bed. Other suggestion is to set alarm, though maybe baby works just as well, so that I get up and go to bathroom every 2-4 hours, or whatever needed to not be incontinent. Thankfully, I am 9 months post takedown and most nights I can go 6-7 hours without getting up. Heaven! But, I guess you will be dealing with sleep deprivation for awhile with new baby. Good luck! You'll get there! LJZ
Coming from someone with chronic pouchitis (not that you have this)...if you currently have pouchitis, you have to treat it. The only way to to truly treat it is with antibiotics. However, once you have it treated, there are ways to keep it in "remission". A true sugar/carb elimination diet should help you tremendously if you are willing to do it. I have tried and failed as I just cannot seem to give up these foods. Thus, I continue to rotate through antibiotics and others that work like antibiotics (Pepto Bismol and Oil of Oregano). Both of those alternatives are off your list if you are nursing. I know that I can't keep this up forever as three antibiotics/medicines no longer work for me at all (Augmentin, Cipro, and Pepto). For now, I'm rotating Flagyl, Xifaxin, and Oil of Oregano. Hope you find something that works for you.
Hi! Congrats on your new baby!

I had lots of incontinence issues in my six weeks post op after my babies and it got better. However, nightly problems only got worse in the years to come. I found switching to the SCD/GAPs Diet totally stopped night time accidents for me, however this was a HUGE commitment.

Kegels again?

I also found I had more accidents when I was really, really tired (which I'm sure you are!).
Laura
Yes, clz81, I'm totally for antibiotics when I have pouchitis and those help tremendously but I don't want to become dependent on them if I can help it. If I can prevent pouchitis from coming, that would be terrific. I have oil of oregano but I want to wait until I'm finished breastfeeding to try it.

I've tried a sugar/carb elimination diet too and I have had a hard time sticking with it too. I find I'm okay to go hard-core for a month at a time and limit sweets in between (but I really have to get back to eating healthy....a new year's resolution of mine.)

I find that getting up at night or setting an alarm does not help...I can go to the washroom and 1 hour later have an accident in my sleep.

Thanks LHettie for your advice on the SCD/GAPs diet. I'll look into it! I have found home made kefir to be very helpful thus far!

Thanks ladies!

Hi!

 

I had a c-section three months ago and having lot of problems ever since with my j-pouch. Pregnancy went really well, but my cuffitis came back and is troubleling me a lot. It causes night time incontinence too and lot of gas and pain. I find it very hard to function with practically no sleep at all. I'm nursing my baby and my doctor put me on flagyl and cortisone locally but those doens't seem to help. Wondering too about trying some kind of diet changes.  How do you others manage with small babies and j-pouch problems? 

Hi Joza,

 

I must say that although I once in awhile still have night time incontinence, I have found something that has made me feel immensely better!

 

I discovered that night time incontinence came on when I had a very mild form of pouchitis...no bleeding, just urgency with little output (except at night...hence the problem). I found that deep fried foods, pure chocolate, apples and popcorn were terrible for me, so unless I have them early in the day, I avoid them. I also started taking Kefir which has made the biggest change! I have not had pouchitis since and I'm only sometimes incontinent if I eat the above "bad" foods.

 

It's natural, yeah it's a bit weird but it's kind of like a combination of yogurt and milk that you can make at home. The reason it works so well is because it has so many probiotics. One glass has 5-10 trillion and 50 different strains. That's more than a whole bottle of probiotic pills that you buy. The best part is that it costs the same as milk...which is why you don't hear the health community talk about it a lot...they don't make money from something you make at home.

You'll have to find kefir grains from someone who makes it or you can buy them online. I just posted a request to my facebook friends and was surprised how many make kefir, so I don't think the grains will be too hard to find. It is sour and takes a bit to get used to. I put stevia in mine but lots of people use it in smoothies. 

I think the reason why it works so good for us is because we don't have a colon to store these probiotics. We need to take in probiotics from sources like this. 

There are so many helpful tutorials/videos on youtube that show you how to make it. Feel free to ask me any questions!


So good to hear that you are doing better ☺.
And thank you for sharing your advice on kefir��

I just wanted to comment on Allbran that you were eating. Don't the contain a lot of sugar?

When I have 'running' issues I eat HUSK. Perhaps it is called something else in English. It is shells of psyllium seeds. Very effective and 100 % natural without sugar or anything else.  I always carry them in my purse.

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