Archive Questions

Here's some older questions you have asked with the answers below them.


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Medications & Diet

I had my surgery 2 months ago (J-pouch) and I am still having discomfort. I have been taking Darvocet-N 100 and that seems to help me relax a little, but I am concerned that I may be getting addicted to it physically or mentally, I am not sure. I am planning to travel overseas for three weeks and I don't know if that is the right thing to do right now. I would also like to know if there are any medications that may help decrease number of bowel movements during the day. Also what kind of foods do you recommend at this time to help reduce the discomfort and irritation. Thank you.


Many of the people in our support group are placed on immodium and metamucil or citracil. Also, apple pectin helps to control the number of bowel movements. Pectin and metamucil are over the counter. You should not be having so much pain 2 months post-op. You may have a stricture at the site where your pouch joins the rectum. Some people have pouch spasms. You should keep a record of what you eat and the way your body reacts. Alcohol can cause problems and some people are lactose intolorent, which causes problems when milk and dairy products are consumed. Lactaid products could help with this. Otherwise have patience as the pouch needs time to mature. Travel is OK, but watch fresh foods, fruit and water. Pack bottled water and toilet paper.




Dear Grace,
Hello. I have been diagnosed so far with ulcerative colitis. I was hospitalized for several weeks at Mount Sinai Hospital in New York City and recieved cyclosporine treatments and cortisteroids. I have now been home for 2 months on oral cyclosporine and prednisone. I have had every side affect you can have. My problem now is that they still cannot determine if i have Crohns disease, which my father has and there is a possibility that I may have it.
Is it possible to have both ulcerative colitis and Crohn's disease? , and what about surgery? , Can I still have an ileo anal done? Or will this interfere with the Crohn's disease if I have it. I am very confused. If they could tell me I only had colitis I would be on the cutting table tommorow, but I donÕt know if Chron's will interfere. Can you help give advice on this matter. Thanks.


Thank you for your message. There are many people like yourself who have difficult to diagnose; ulcerative colitis vs Crohn's disease which is sometimes referred to as "indeterminate colitis". Whereas in most cases, the differential diagnosis is easily made with a biopsy, in indeterminate disease, this is not so. Additional evaluation is needed. This makes your care more complex and therefore understandably more confusing. Fortunately, you have selected a place where the doctors see many patients with inflammatory bowel disease and have a great deal of expertise in handling difficult situations like your own. Sometimes, it takes time to sort this diagnosis out.

It does sound like there is somewhat of a communication gap between your physician and you. It might be a good time for you to sit down and hash out the questions that you've raised with your physician. It's a good idea to take someone else with you and write down all of these questions ahead of time. It's very important for any patient to be able to talk comfortably with their doctor and get the information that they need. Not all the questions will necessarily have an answer right away, but patients should leave their office visit with a general understanding of their condition and course of evaluation or treatment.

In general, j-pouch surgery is only for patients with ulcerative colitis or familial polyposis. It is not for patients with Crohn's disease. There are approximately 10 percent of patients with Crohn's disease who have "Crohn's colitis" which is Crohn's disease that just involves the colon. J-pouch surgery is not indicated for these patients either. If your doctors determine that you most likely have ulcerative colitis, then the j-pouch may be the way to go.

Let us know how you make out. We wish you all the best!
Good health, Grace




My husband is 1 year post op j pouch. Takes immodium, psyllium seed fiber, tinc. opium, iron, & still has 15 BM per day at least. Does not have pouchitis. Surgeon does not seem to know what else to try. My husband is very discouraged. Any suggestions? He has been to colon surgeon, gastroenterologist, internist, hypnotist, psychiatrist


People adjust at different rates to their pouches. It is hard to make the transition. I would suggest checking foods as this can sometimes be the culprit. Try something bland like pasta, rice, mashed potatoes and add vegetables and meat one at a time and check results. If diarrhea occurs, eliminate that food. Does he have a lactose intolerence?
Also try Metamucil wafers instead of psyllium. Pectin (from apples) also has been found to be effective. He should also practice holding the urge to go for a time (10-15 minutes if possible), increasing the intervals to increase pouch capacity. Be aware he will have the urge 30-45 minutes after eating. Some people have tried biofeedback with some success.
Sometimes, patients have irritable bowel syndrome along with their inflammatory bowel disease. Therefore , some physicians have tried to use medications that help with the irritable bowel syndrome and at the same time, improves their pouch function.
Good luck,
Grace



The information provided through this ileoanal web site should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.

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