Salad is one of those interesting things that can cause all sorts of problems. One thing that many people forget is that salad needs washing and often this is done under the kitchen tap. Depending on where you are in the world, you could be introducing bacteria to your meal from the tap water. Consider old pipes, old infrastructure, does the local pumping station need to be dosed with a sanitiser (ie chlorine), are you in the tropics where giardia is often present in the water supply. (Also note that the treatment for giardia is the same treatment for pouchitus ie metronidazole)

 

The other thing to consider about salad, is the dressing. I have a reaction to Palm Oil and, because it is cheap, many companies are substituting this in the manufacture of many food products such as instant coffee mixes, salad dressing, sauces etc.

Is a specific in the salad causing a problem? You may have a mild allergic reaction to one item that, without a large bowel, causes the flow to hasten through. (shellfish, such as shrimp, takes the rapid route of 3 minutes from hitting my stomach to exiting...seriously!)

Final thought is use of a binding material. If I have a meal such as a salad, I will also try to include a side dish of pasta or rice or even a heavy dough bread, to help bind the other parts of the meal into a more solid mass which then slows the motility down.

 

 

I probably clicked on the wrong answer as there isn't a 'device' but there is a 'method' of greatly reducing the problem. I have had my J Pouch now for 30 years and, over time, my sleep position in bed has just about been locked in concrete...seriously, I no longer turn over during sleep and I only turn over if I wake up first and make the decision to turn over.

 

Firstly, someone a long time ago told me that your stomach empties faster if you are lying on your right side. I found in my case, this was true and I'd wake up either needing to go to the toilet or due to incontinence. Over time, somehow the brain/body learned not to turn onto the right side. If I woke up on my right side, feeling like I had to go to the toilet, I'd return to bed and lie on my back. This reduced my night time incontinence and/or waking up to go to the toilet considerably. If I try to lie in that position now, it's actually painful after a short period of time,  as the body has not rested in that position for so long, that my joints are no longer flexible enough to lie comfortably.(I'm 56 and starting to feel age related joint pain allover so this is a fair assessment.)

 

Over time, I also learned that lying on my back also reduced the need for me to get up at night as I didn't 'feel' like I needed to 'go', so I didn't wake up as much. Lying on your back also puts pressure on the anal region and reduced, for me, any feeling of fullness needing attention at some point. I was very very very rarely incontinent in this position unless I had a problem with giardia or pouchitus which then required medication. ...oh, and shellfish....I also found that without the large bowel, any minor reactions to some foods that were never apparent before definitely now had to be excluded from my diet.

Anyway, it was a slow process of 'training' myself and I didn't even realise I was doing it until recently. I do NOT move in my sleep at all anymore and I sleep on my back 98% of the time. Some people think this is impossible and that, of course, I move my position. Trust me, I don't and for me this allows me to seldom wake up at night any more. It's worth a try as it doesn't cost anything and it will take some time to 'train' your body, it certainly won't happen over night.

 

 

Ok... So I am still learning after all these years. I have tried everything to slow down the loose BM. Lost colon in 1988 slow down great by 1997. In 2000 I went to 25 BM a day. I am down to around 12-17 a day and now with stage 4 kidney damage because of long term fluid loss. I started taking Gattex shots in my belly in July 2015, no help yet. Its a new treatment.

I don't want to go on dialysis. I have tried...Imodium, lomotol,colostrum powder, flagel. another shot in the belly ( I cant remember name), probiotics, Cipro, loratab, codeine,and some things I can't remember. Any ideas?

By the way... VERY IMPORTANT... use AQUAPHORE with HEALING ointment  in it to help the skin irritation with the loose BM. put it on each time and wipe. It does not sting and it helps heal.  Buy it at at grocery store in the hand lotion area. Thx...

I have had my J-pouch this March 18 years

what I have learnt, is that i will always have 10-20 dm's a day depending on my diet, or a hard night of drinking haha.

I also learnt, never trust a fart unless you are indeed on a toilet, that fart could be loaded. haha... Also I know, i have to get up every night, to empty my pouch 1-3 times.

I have had lots of trials and errors with my pouch.

Although I have not had this particular issue, i may know of an affordable solution.

 

There is company called Coloplast.

They are Ostomy and incontinence specialist.

If you call their 800 number, they will send you a sample for free.

They have a medical anal plug (think tamponish, with string, only different).

I believe anyone can wear these, and they much more readily available, and more affordable, then the Medtronic solution provided lower down. 

I have no skin in the game, but i know they work well.

 

I thought I did.

I've had the problem since I had the operation.  One doctor said "pouchitis" or Crohns and had me on cipro.  I don't know that it made any difference.  The compounding problem is painful anal irritation but Calmoseptine helps.

 

Daytimes are usually OK but late afternoon through midnight are problematic.  Alcohol anytime is a no-no as are too many raw fruits and veggies, especially late in the day.

 

I take Immodium before eating and Lomotil at bedtime.

 

BUT I'm now taking Lialda, which is like Asacol, and it works!

 

My solution for accidents is Viva paper towels with thin pads underneath.  The towels are the softest I can find so they don't scratch, and I carry a bunch in my purse.  Easy to toss when messy.

Hi there, 

I have had my J-pouch for 5 years and mostly up to 15 -25 BM a day on normal diet but if I stick to fillers w/o gluten and easy foods about 9..... I have heard really encouraging news about pelvic bio-feedback therapy and there is a Physical Therapist local to me that is supposed to work wonders with teaching people new techniques for rebuilding pelvic floor muscles that help with incontinence issues associated with rectal / J-pouch patients. I also get severe rectal pain and cramping quite randomly but most often after eating solids... Hoping she can help with that too!  Good luck! 

Wow, Jennifer I use Dr. Jacobson too. He has done me, my Dad and brother. Mine was done in 1990 and I still have my bad nights and I take 8 Lomotil a day.

I've had a pouch for over ten years and have periodic bouts with incontenence.  As others have already stated there are several things that help and others that hinder.  Knowing what will cause you to have gas and how early or late you eat will all factor in.  I try to not eat after eight pm and always potty before bedtime.  These have really helped me.  It may help to keep a journal of the foods you eat and their effects on your system.  That was how I identified what I need to stay away from at night. I recently started taking a probiotic to see if it will help, but not sure it helps me.  I have a 5 to 7 hour cycle when I eat and the probiotics have not changed this cycle.  Best advise is to get to know your body-again.  Things have changed, so learning is fundamental...

I have had my J-Pouch for 25 years. I NEVER had one accident UNTIL...5 years ago I tried remicade to close my fistulas. The accidents started when I started taking Remicade, it was an obvious correlation when nothing else in my life changed except taking this drug...and double doses of it. I have never been the same, at least 2-4 accidents/week, some weeks better, some weeks worse. Can't figure out what triggers it. I have been on the same eating schedule for 25 years, eat no later than 6 pm and I never had a problem. I too can eat anything and don't have any problems; salads, fruit, ice cream, never had food issues. It was never about the food I ate, it was the severity of the disease itself (diagnosed with UC, J-Pouch, Oops - you have Crohn's too).

This is the only reason I'm glad my husband works nights!

it will come and go, it depends on how you lay, how "asleep" you get, what types of food you eat, how much water you drink... after 20 years hey I leak, I sleep with a shet sheet, beats getting up in the middle of the night and having to change the whole bed.  I eat very healthy, drink lotsa water, coffee n wine. I'm a "light" sleeper now and then I will get up and get to the restroom, now if I'm very tired and I really get to that deep sleep, well then I'm likely to leak n be changing my sheet...

There is a device for assisting you with this. It is a Medtronic Sacral Nerve Stimulator. It is a small device with probes that is inserted under your skin right at the top of your buttock. It sends impulses to the sphincter to keep it toned and tight. 

 

Following my takedown after my J Pouch I was fecally incontinent. Was a total mess. I felt the need to hold it but either from birthing four large babies or the surgery, or both, my sacral nerves were severely damaged. This unit was an easy procedure and made a huge difference. As long as I don't have diarrhea, I can hold it and I wake up to go (not wake up in my own mess, which has happened). 

 

It's given me my life back. The same surgeon that did the J Pouch inserted it. I can turn it higher or lower, or even off. My gastro was the one who figured it out though.

Sleeping too deeply can also be a cause.  If I take something to help (Benadryl, Gravol or cough syrup or sleeping pill) it can cause you to miss the signals.

I had a sacral nerve Stumulator placed 2 years ago and it took some time programming it but it does work. It is amazing. Feel free to text me if you have questions (417)621-5309 I went to Dr. Jacobson in Dallas Texas. He is affiliated with Baylor.