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I’m going 7-12+ times per day depending on my level of inflammation. I’ve been fighting chronic pouchitis and/or cuffitis ever since takedown 3 years ago.

Asa Lay, the straining you mention—which for me includes involuntary spasms to push—will definitely wreak havoc on your cuff and anal tissue if you don’t stop it. I have learned to just get off the toilet, otherwise I can sit for a half-hour or more trying to “push” it out. That often leads to slight bleeding, anal pain and fissures that can cause more pain/swelling and the cycle repeats. Still learning how to deal with everything from diet choices to therapy combinations.

 

Too much focus is placed on the number of bowel movements and not enough on (1)  when the BMs are coming- are they spaced out or coming in bursts after eating, the latter of which is indicative of a motility issue, and (2) an increase in the normal amount not driven by changes in diet or size of meals, which as Jfill21 suggested, could be indicative of an inflammation-driven increase in frequency.

In my year or two after takedown, I had severe motility issues, characterized by rapid fire bursts of BMs after meals, which skyrocketed my daily number of BMs.  This situation was corrected by taking an anti-spasmodic drug 45 minutes prior to meals and served to reduce my number of BMs dramatically. Motility issues are very common after takedown and for a few years.

Imodium can also serve to slow down transit time and the number of BMs when the issue is frequency not related to inflammation, although I am sensitive to imodium, and if I take more than a couple a day, my stool thickens to the point where it will lead to pouchitis.

An increase from the normal baseline number of BMs, and you will notice it without counting, often coupled with a subtle increase in urgency, are signs of pouchitis, and proper treatment will quickly restore the baseline and reduce the frequency.

So I do not get caught up too much in counting and numbers as opposed to the timing of the BMs and whether my normal pattern has changed.  Those are the things that matter, and those indicators are cues for a treatment response.  If the baseline is consistent and the BMs are spaced out throughout the day, then imodium may reduce the frequency, with the caveat that if you notice it thickening up too much then back off the dosage.

Last edited by CTBarrister
@Jfill21 posted:

I’m going 7-12+ times per day depending on my level of inflammation. I’ve been fighting chronic pouchitis and/or cuffitis ever since takedown 3 years ago.

Asa Lay, the straining you mention—which for me includes involuntary spasms to push—will definitely wreak havoc on your cuff and anal tissue if you don’t stop it. I have learned to just get off the toilet, otherwise I can sit for a half-hour or more trying to “push” it out. That often leads to slight bleeding, anal pain and fissures that can cause more pain/swelling and the cycle repeats. Still learning how to deal with everything from diet choices to therapy combinations.

 

I never knew that! Thanks for sharing

@CTBarrister posted:

Too much focus is placed on the number of bowel movements and not enough on (1)  when the BMs are coming- are they spaced out or coming in bursts after eating, the latter of which is indicative of a motility issue, and (2) an increase in the normal amount not driven by changes in diet or size of meals, which as Jfill21 suggested, could be indicative of an inflammation-driven increase in frequency.

In my year or two after takedown, I had severe motility issues, characterized by rapid fire bursts of BMs after meals, which skyrocketed my daily number of BMs.  This situation was corrected by taking an anti-spasmodic drug 45 minutes prior to meals and served to reduce my number of BMs dramatically. Motility issues are very common after takedown and for a few years.

Imodium can also serve to slow down transit time and the number of BMs when the issue is frequency not related to inflammation, although I am sensitive to imodium, and if I take more than a couple a day, my stool thickens to the point where it will lead to pouchitis.

An increase from the normal baseline number of BMs, and you will notice it without counting, often coupled with a subtle increase in urgency, are signs of pouchitis, and proper treatment will quickly restore the baseline and reduce the frequency.

So I do not get caught up too much in counting and numbers as opposed to the timing of the BMs and whether my normal pattern has changed.  Those are the things that matter, and those indicators are cues for a treatment response.  If the baseline is consistent and the BMs are spaced out throughout the day, then imodium may reduce the frequency, with the caveat that if you notice it thickening up too much then back off the dosage.

My 10+ bowel movements are normal for me. I always had that for almost 6 years. I did take immodium in the past after take down but now since it has been years, Immodium clogs me up. I stopped that about 5 years ago.

@Jfill21 posted:

I’m going 7-12+ times per day depending on my level of inflammation. I’ve been fighting chronic pouchitis and/or cuffitis ever since takedown 3 years ago.

Asa Lay, the straining you mention—which for me includes involuntary spasms to push—will definitely wreak havoc on your cuff and anal tissue if you don’t stop it. I have learned to just get off the toilet, otherwise I can sit for a half-hour or more trying to “push” it out. That often leads to slight bleeding, anal pain and fissures that can cause more pain/swelling and the cycle repeats. Still learning how to deal with everything from diet choices to therapy combinations.

 

If your pouchitis does not get controlled, do you think you might want a permanent bag?

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