Hey everyone

After being a passive reader for quite some time, I decided it's time to join the community and take part of it. 

Long story short, I got my j-pouch some 40 days ago and have had my ups and down. To skip through my journey, I would simply like to hear whether j-pouchers can go through the night without going to the toilet. Or at least keep it at once a night and if so, after how long post-surgery? 

I tried imodium, which didn't seem to have an effect.
I tried husk once, which may have helped but it made the stool so consistent that it hurts (due to analfissure).
I tried going 5 hours without eating/drinking pror to going to bed and still I had to go 3-4 times. 
I'm staying away from caffeine, juices, fruits, veggies, nuts, chocolate.
Not suffering from pouchitis so let's get that cleared.

I would love to hear how people around here are doing and how they've progressed after their surgery.

Stay strong and focus on blessings. All the best. 

Last edited by Makaveli
Original Post

Hi, Makaveli. I generally sleep through the night without interruption. I think in the still-early days one of the key things to do is what is sometimes called “stretching the pouch.” This is simply extending the time between BMs during the day, gently and gradually, along with kegel exercises. Explore the changes you go through from noticing that there’s something in your pouch eventually increasing to a strong feeling that it’s time to use the toilet.

Other observations:

1) I have better luck with Lomotil at bedtime than Imodium 

2) You can use a smaller dose of psyllium husk - there might be an optimal amount that you would find useful

3) A small, fatty snack at bedtime (e.g. a spoonful of peanut butter) works well for some people by slowing things down

Good luck!

Fairly decent pouch for 3 years and I still get up once or twice a night no matter what.. can usually get back to sleep quickly so not complaining, but not ideal.

Hi, Makaveli. Your pouch is brand new and your system is learning how to work with its new life. It took me almost a year before I could sleep through the night. In the beginning for a few nights I had to get up every 15 minutes, no joke. I feared this was my new life and I would never get a decent night's sleep, itself a serious health hazard. But it did get better and I now sleep through the night, or get up once to use the bathroom. I eat everything except seeds or nuts, and I sometimes eat late in the evening. I have no problems with urgency, frequency or leakage at night because of this. Sometimes you sleep better with a small amount of high protein food in your stomach. Hard cheese on crackers, peanut butter on toast, a cup of pasta?  Maybe, for now, stay away from raw foods, raw salads, hard fibrous vegetables. Stick with soluble food so it exits your j pouch easily and you have some control. Steer clear of processed food, but eat broiled or grilled fish, baked chicken, tofu, roasted vegetables, homemade soup, or store bought homemade soup!  I ate one egg per day after my takedown for the protein, soft texture, and vitamin B12. I also ate lots of steamed spinach. Yes, it's mushy, but full of nutrition and I didn't have problems with cooked spinach. I had broth every day for the salt and hydration. Give yourself more time and try not to worry.

Thank you all for taking the time to read through my post and replying. Much appreciated.

For the first time since surgery, I only had to go to the toilet twice last night. And I am certain it was by no coincidence. Peanut butter is underrated! Forget meds, peanut butter is simply a must have. I'll go with eating some in the morning as well, it could slow things down further during the day too. The docs left me with nothing to go by yet this forum... pure gold!


@Scott F Great idea on trying out husk in a small dose. Regarding Lomotil, I prefer waiting on trying too many things until I find a diet that works for me, which is not easy to say the least. 

@Winterberry I do realize it is new, which is something I've been told over and over again. It is the unknown as to how long I can expect for things to get normal that bugs me. That is why I was hoping to give some insight as to how long it took for some of you guys to reach the point where you went "alright this is as well as it gets"

At 10 months by best nights are one wakeup, but two is more usual.  On bad nights when my pouch is irritated or I ate too late I might be up and down for a couple of hours without getting back to sleep.  So, eating later at night is my worst mistake - I'm best off when there's four hours before bed and I empty the pouch well then wash and dry.  If I do eat anything, I follow Scott's advice and have a little pbutter or cheese.   My doctor said never to eat & drink at the same time.  So I'll eat and then an hour later I will drink.  Sometimes I wake up and am able to ignore the pouch and fall asleep again - you will get better at holding and the frequency will slowly drop.   Plus once you learn how to pass gas you may be able to delay getting up.  Doc said it takes a full year to get used to the new plumbing.   When I have really watery output that won't stop I use lomotil.  

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