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Reply to "Incontinent but with good sphincter muscle tone"

Nick, can you tell if the burning is internal (within the anal canal) or external?

I take a Lomotil or two at bedtime to help slow things down during the night. I find it works a bit better for me than loperamide (and I never tried codeine or other serious opiates for this purpose).

Something is irritating your innards, and it’s not the spacing of your antibiotic doses. You might just be in a cycle where frequent poops irritate things, causing leakage and frequent poops. Breaking that cycle can be tricky. It’s possible that this is cuffitis rather than pouchitis, and that would be treated with some form of mesalamine rather than antibiotics. It’s also possible you’re still adjusting, since it’s only been four months, but it sounds like a difficult adjustment. I still think you need a trial of psyllium soon (I’ve used it every day since my surgery, and it really helps in my case). You’re probably doing enough kegels. Maybe you can ask for that pouchoscopy sooner rather than later?

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