I did a search of posts for having constipation with a J-Pouch.  But I am unsure what to do.

I have gone from having to take meds and Psyllium husk to slow my output frequency/watery output to having an issue with constipation/unable to fully evacuate my pouch with no meds/Psyllium husk. 

Regardless of what I eat in the morning, I end up having multiple trips to the bathroom, unproductive BM's, inability to fully evacuate my pouch, and leakage during the day.  I am on my feet all day at work and bending/twisting can cause leakage as well.  The amount and type of food I eat makes no difference on my ability to fully evacuate when having a BM.

I get days where I get home from work and my output turns to water and I have done nothing to cause it or eaten anything in hours.

I drink upwards of a gallon of water daily.  So dehydration should not be an issue.   Will taking Miralax help?  Even hot sauce didn't help (when I ate it on eggs today).

Original Post

I’d guess you might have a stricture rather than constipation. Is there a particular reason you think it’s constipation? Go easy on yourself, and try not to strain. This would be a good time for a pouchoscopy if we weren’t experiencing a pandemic. Maybe try to schedule one with your GI for 8-12 weeks from now, and hopefully it will seem like a good idea as that time approaches. You could also call your GI for some advice.

Thanks Scott.  After I posted, I  thought back and remembered that I was having very similar issues back in January of this year.  I made an appointment with my surgeon and that is what I had, a stricture.  He dilated the stricture and things were much better.

Until I can get in to see my surgeon, can I take Miralax safely to help keep things flowing better?  Or can an individual self dilate their stricture?  

Self-dilation is safest when it’s used to maintain an opening created “professionally.” Some folks here do it all the time, and can give you better advice than I can about how/when/whether to do it. You do have to be careful and understand the proper angle and depth of insertion, and the diameter your stricture will tolerate. It can be very painful to enlarge the opening appreciably, so anesthesia is commonly used by the pros.

It’s certainly worth preventing anything from getting trapped behind the stricture, and solid stools are not your friend. Liquid stools are probably safest, but they are unpleasant and irritating. More important than Miralax, I suspect, is to stay away from insoluble fiber or anything that might still be solid at the outlet: skins, seeds, spinach, etc. Drink plenty of water. If this gets extreme then dilation is no longer elective and you might need to get it done in spite of the inconvenient timing. Stay safe, and good luck!

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