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Reply to "New Jpouch-er"

The purpose of psyllium for J-pouchers is to bulk up the stool. I find it works best if taken with meals, so the residue doesn’t emerge as an overly loose BM. I take it before breakfast and dinner, but I want my appetite suppressed a bit. If you’d prefer to gain weight then after meals is probably the better choice.

Itching at the outlet can come from irritation or from fungal growth. I’d suggest a bidet attachment for your toilet - there are inexpensive ones that work fine, and there are also fancy ones with heated water, heated seats, and air dryers. In any case it’s important to keep the area protected and dry to inhibit fungal growth (athlete’s butt?). If you aren’t using a barrier cream after each BM now might be a good time to start - I did this religiously for a year or two after surgery. Simple zinc oxide works fine, and some people prefer fancier stuff, like Calmoseptine.

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