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Hello! I hope you guys are doing well today! I just wanted to see if something I'm experiencing is normal at this stage--7 months post-takedown. I still feel like I'm spending a lot of time in the bathroom most of the times I go. I feel like my pouch only empties a little at a time. Like I go some, sit for a bit, and go some more. That usually happens a few times before I really feel done. This isn't a problem when I take psyllium husk, but it's also the only reason I would take it at this point. Everything else is fine, and I am feeling great. 

My surgeon mentioned the possibility of doing a pouch exam when I told him this, though he also wasn't really concerned. I'm just not convinced that I need to go under anesthesia and go through that whole process right now for this level of a complaint. Without any problems, I'm not supposed to have my yearly pouch exam until April.

What do you guys think? Thanks!!

 

 

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My doc asks me if the number of times I’m going is something I’m comfortable with. I’m 9 month a post takedown and still around 10-12x/day. He tells me “we can do bette than than, but if that number is something you’re comfortable with then we don’t need to do anything. 

I said I’m fine with 10x/day but if he can make it less, I’m all game! He added Questran, which is a prescription powder originally used for high cholesterol. I was taking that an addition 2x a day, but I had to stop when I found out I was pregnant. I haven’t tried the Psyllium husk but it sounds like the same, but just more natural than the chemical/prescription he gave me. It’s up to you, as to what you feel like is adequate in terms of treatment or if you want to step it up. 

A pouch scope may not be a bad thing. My doc did one to eliminate pouchitis with me still going 10-12/day this far out. It was a breeze and reassured me everything was in working order. 

You get *much* better mixing of psyllium if you shake rather than stir. I use 16 oz. Mason jars with plastic screw-on lids to shake things up. Konsyl has shaker cups, but they don’t hold up very well, IMO. I use the full recommended 8 oz. of water, and that works fine for me, though many folks here prefer less water.

Bubba1028 posted:

My doc asks me if the number of times I’m going is something I’m comfortable with. I’m 9 month a post takedown and still around 10-12x/day. He tells me “we can do bette than than, but if that number is something you’re comfortable with then we don’t need to do anything. 

I said I’m fine with 10x/day but if he can make it less, I’m all game! He added Questran, which is a prescription powder originally used for high cholesterol. I was taking that an addition 2x a day, but I had to stop when I found out I was pregnant. I haven’t tried the Psyllium husk but it sounds like the same, but just more natural than the chemical/prescription he gave me. It’s up to you, as to what you feel like is adequate in terms of treatment or if you want to step it up. 

A pouch scope may not be a bad thing. My doc did one to eliminate pouchitis with me still going 10-12/day this far out. It was a breeze and reassured me everything was in working order. 

Bubba1028, when you took the Questran did it reduce your frequency? Also are you experiencing pain or soreness from 10-12x per day? I’m almost 9 months out from take down and have similar frequency, but still dealing with discomfort. 

I agree with Bubba that you should have a Pouch scope and there should be no reason to hesitate particularly if the incomplete evacuation issue persists. In my case incomplete evacuation is a sign of pouchitis and the Pouch losing its elasticity due to inflammation.

I get scoped every year for my 26 years with a J Pouch due to my dysplasia and pouchitis history. I have had Propofol (anesthesia), conscious sedation, and no sedation. All 3 options exist. I do agree the pain is minimal/tolerable as compared to the unsedated colonoscopies I had done back in the 1970s when it was believed children should never get any sedation. However I choose conscious sedation as a matter of personal preference and have my office manager drive me to and from the procedure. I think you should pursue it if the incomplete evacuation issue persists or worsens.

Back to the original question about how many times a day -- everything you describe sounds like how I was during my first year. Now, I think I probably go about 8 times a day, which I know is on the high side. This is my second year with the pouch and I think last year I was going a little more often. (It doesn't bother me, since I don't feel sick like I did with UC.)  I, too, have difficulty emptying sometimes, but I just try to have patience and ignore it.

To slow things down a little, I take two immodium per day and, instead of the psyllium husk powder drink, I eat Metamucil fiber thins. (They're like cookies, basically.) The new chocolate flavor is very tasty. I'm not excited  about eating these things every day for the rest of my life but they do seem to help a lot. And I'm not good with powdered drinks, plus I'm already trying to work VSL powder into my day. So the fiber cookies work for me. I recommend them. I wish I'd known about them sooner.

About the previous post from DAM UC -- I've had something similar. I found that taking a Gas X always helps. 

 

JHendrix posted:

I'm with Scott on the psyllium husks (only I take a heaping Tablespoon four times a day...after a meal and before bed).

Hi there, I was just curious to read that you use the psyllium husk ‘after’ a meal. I use the husk, but it’s ‘before’ meals. It does help me with having more formed stools, but I still use the bathroom so often it seems?? I may try the opposite and do as you do...my only concern would be gas problem, because that stuff really turn into a thick gel/gravy consistency when used. Have you used both ways and it to work better when use  after meals?? I had a J pouch for about s 10 years now. Thanks, hope to hear from you. Cindy

I know that many people use the psyllium/metamucil before meals instead of following food. I've tried it before food a few times but my 'gut' tells me to take it after a meal.  My thinking is that it kind if mixes with the food to provide the bulk instead of going through on it's own prior to food. I really don't know if there's any actual legitimacy to my 'logic' but it works for me. 

Re gas, I'm not sure about the effect of psyllium on gas for me. I hadn't thought if it being a contributor.  (And I don't think I want to eliminate it s a test. )

Also, I probably use the bathroom more than some would find acceptable (usually 8, sometimes 10) but for me as long as its comfortable and not watery I'm fine with that. (Maybe I just eat too much!!)

  

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