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After suffering at least 12 years with J-Pouch related issues/discomforts, it seems that I've encountered a solution.

Before I go into this very interesting topic, I must inform you that I just spent 18 hours without eating or ingesting fluids and endured 8 hours in the radiologist's office having x-rays of my small intestine and J-Pouch (routine procedure). So, I'm a bit drained; meaning that the following description of what I've done over the past 9 months will be semi-brief. Last week I had my first upper-endoscopy in 8.5 years and the gastroenterologist ordered the x-rays since he found polyps in my duodenum.

That said...

Before March 2014, I suffered greatly from Pouchitis and bathroom-related sleep disturbances (name it, I suffered it; to spare you the details). I awakened in the night on the average of 3 times; leading to Adrenal Fatigue that mimics hypothyroidism due to cortisol dumping. I weighed at least 33 pounds more and couldn't drop the weight with exercise and with controlling calorie intake/fat consumption. I couldn't eat fruit, vegetables (raw and cooked), seeds or nuts without having issues with diarrhea/blockage (at the same time). I blamed it all on the fibre... and bought a Vitamix Blender believing that would solve the problem. Truthfully, it didn't. What I believe was the problem was chronic inflamation. Today I can eat anything natural I want without suffering the consequences, since the fibre wasn't the culprit.

In March I removed most refined carbs (simple carbs) and removed all wheat products (I don't believe that dramatic wheat-related health issues are limited to those with Celiac Disease nor are they limited to gluten in wheat). I do consume added sugar (maximally 24 grams/6 teaspoons per day) in my coffee or occasional lime/Flaxseed water... I eat occasional corn tortillas and occasional sweet potatoes or plantains (I discovered a wonderful flourless pancake recipe that utilizes blended plantains instead of flour). I do not limit my fruit intake, especially if it is high in fibre, especially if it is high in vitamin C. Aside from the occasional corn tortilla, I'm not eating corn on the cob or corn kernels. I'm also not eating potatoes. One more thing; I've greatly decreased my usage/consumption of commercial vegetable oils, including Canola, since they are very high in pro-inflamatory Omega 6 fatty acids; we obtain enough Omega 6 in our diet of animal fat and vegetables. The vegetable oils throw us way over the top and create an extreme Omega 6/Omega 3 imbalance. I don't drink sodas or fruit juices, since fruit juices often have more added sugar than do sodas. (Just a note: commercial cerials and flavored yogurts generally have more sugar than do sodas or cakes; just in case you thought you were giving your children healthier food in the name of Dannon or Kelloggs...) I'm not drinking alcoholic beverages, since alcohol affects the liver just as does fructose (Another note: Parents, if you thought only alcoholics suffered from fatty liver disease that converts to cirosis, today you will be seeing an epidemic in fructose related non-alcoholic fatty liver disease in children, adolescents and young adults. Have you noticed pot-bellied children?... 6-year-old boys and girls with beer-bellies for instance...)

Without exercise, both my wife and I lost around 22 pounds in 3 months. Then we found that we could exercise more easily and withstand longer periods of exercise in the past. We also found that we endured much longer periods without eating. Diets high in refined carbs cause hunger on the average of every 2 hours. Diets high in protein cause hunger on the average of every 5 hours and diets high in fat cause hunger on the average of every 7 hours.

When we all but removed the refined carbs from our diet we increased greatly our consumption of fat and complex carbs. We always had a diet high in protein. But, without "cutting" the protein with simple carbs (rice, bread, pasta, potatoes, tortillas) we realized that we must cut it with fresh fruits and vegetables, which was a severe worry for me, considering the havoc fibre reeped upon my digestive tract. After 9 months of this incredible experiment, I've realized that what caused the issues was NOT the fibre or the fresh fruit and fresh and cooked vegetables... It was the refined carbs, the wheat products and the commercial (Industrial) vegetable oils.

In 9 months I've lowered greatly my triglycerides, my blood-glucose and my total cholesterol, while raising my HDL cholesterol... while eating much animal protein and animal fat (especially eggs and cheese). Due to work intensity between late September and early November I spent 7 weeks without any exercise and with an increased consumption of animal protein and fat, cheese and eggs and noticed a decrease in cholesterol, glucose and Uric Acid (Uric Acid is supposedly related to high consumption of animal protein and considered a risk in both gout, rheumatoid arthritis and kidney disease). And I didn't gain weight with the 7 week hiatus from exercise.

I cannot over-stress a very important point: calorie counting and lowfat dieting has absolutely nothing to do with health and weightloss. More accurately: I don't worry about my calorie count or fat consumption (animal fats from chicken, beef, cheese, yogurt, cream, butter...) and I have blood tests every 2 months and my wife's and my weight measures and physical appearance as the testiment. Daily exercise increases muscle mass and may prevent weight loss, although the body becomes trimmer and more attractive. However, if you are concerned about being able to tell people that you continue losing weight and you don't... you must maintain faith in how you look and feel and forget about the numbers you believe they seek for truly believing you.

All this said, most importantly is the fact that I sleep through the night and don't suffer blockage/diarrhea or pouchitis.
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RJG,
Sounds like the way that I lived from around 1990-2009.
From the time that they created my k pouch in '79 to 2009 I suffered from pouchitis (no one told me what it was or where it came from, just that I had it and that I had to take antibiotics...lots of them).
My pouch was unruley and difficult to empty due to the stuff in it being too thick...so I drank gallons of prune juice and coffee to counteract the thick gunk.
It was pretty much a cycle. Bread, pasties and cakes, milk products and prune juice. Very few fruits or veggies unless I wanted to deal with clogs and I didn't live in a country or have a lifestyle that could afford clogs and bathroom time. (I had moved to Paris in '83 and they were reknowned for lousy bathrooms).
Sometime after a pouch revision surgery (it fell off of the wall and was putting tremendous pressure on my girly organs and bladder along with a case of salpangitis and assorted cysts)I spent time in Toronto healing and read a book called Fit for life.
It really did change mine.
I learned about foods, food groups and dissociating them (only carbs or proteins in a meal and fruit on its own, limiting diary etc).
I gave up most diary, ate lots of fish and chicken, eggs and unpasturized cheeses etc and lots of fresh fruits and veggies.
My energy level soared, I could digest most fruits and veggies (still avoid leeks, pineapple, mushrooms and corn but can eat a lot more variety than previously) and didn't suffer from the 4pm exhaustion of the previous years any longer.
It is 25yrs later and when I fall off of the wagon and eat refined carbs, both starches and sugars, I feel it. I drag my butt, am chronically exhausted and need constant naps, live in a fog and suffer from chronic inflamation. I put on weight too.
I just had a few good months and dropped about 10lbs. Too bad I fell off again (birthday cake and co.). I have found that if I start the bread/cheese/sugary stuff then it takes me a week to detox from it all and find my balance again.
I have a very hectic work routine with lots of public transportation and walking, 12hr days and a lifestyle that doesn't allow for more than 5 minutes in the washroom. I eat an apple or banana, some cheese, dried fruits & nuts all day long and have a homemade veggie soup & tea when I get home.
I am no angel but find that this works best for me. Once I start it is easy to stick to it.
Who would have thought that carbs were my enemy?
Diet is not a cure-all but it surely helps a lot.
Thanks for reminding us of the virtues of a pouch-healthy diet.
Sharon
something similar happened to me Before J-pouch and suffering with UC I tried the gluten free diet unfortunately it didn't help I was to far gone. I had j-pouch surgery 4 years ago and was still suffering with food. I decided to go back to gluten free after reading some ones post a few months ago stating that it helped them. So far I am eating foods that I could not eat before . I am making smoothies with different types of fruits and vegetables that I would have never touched before I try one thing at a time to see how it agrees with me. I still can't seem to gain weight. Also I only eat or drink dairy free products. My issues are not as bad. I do have a problem with constipation and that is because of the strictures. I did read that some of you drink grape juice and that seems to help I haven't tried that yet. I have been taking miralax. My gastro suggested Milk of magnesia I will let you know how it works. I do take vsl#3 and trying to cut back on anti biotic. I don't know if I am doing the right thing but then again I never know what is going to work. I have been trying gluten free for about 1 month but sometimes I go off a little but mostly eat gluten free. I will let you know how it works. That is wonderful that you have found a way to make your life less stressful keep up the good work Health to all Grce
Hi JHendrix, Truthfully, I didn't know about SCD: the Specific Carbohydrate Diet. But, at this moment I opened up SCD lifestyle. Being that my "illness" isn't Crohns or IBD or UC, I lived greatly out of the loop of medical experiences/frustrations and hopeful solutions that I imagine most of the non-FAP/Gardners Syndrome J-Pouch community (which is at least 99.9% of the community) know. I've read and learned a ton over the past years, especially over the past 10 months. I've considered AGEs and FODMAPs and read about Celiac, although I don't believe that I would be diagnosed with Celiac and wouldn't return to gluten just for being evaluated. Thinking about FODMAPS and the argument that there is no Gluten Intolerance but a reaction to FODMAPS and that IBD is an issue purely about FODMAPS, I flit my hand as if shooing away a fly. Why? because most of my issues disappeared without removing most FODMAPS. And after reading about high sulfur content vegetables (Onions/Garlic) for balancing out the AGEs in heat chained proteins and about the need for sulfur with vegetable protein for building cell membranes etc (I'm not vegetarian, but understand that not everyone eats animal protein all the time or enough for subsistence; actually most humans don't eat animal protein regularly, but they need protein, fat and cholesterol for maintaining their bodily structures amongst many other things... and the sulfur in the onions and garlic can't hurt...) So, maybe it is something else... And has anyone studied what forms more AGEs in the human body; excess sugar or heat altered protein? What causes breast cancer; genetic propensity or too much sugar in the diet considering that diabetic women have a 300% greater risk of developing Breast Cancer than non diabetic women. But, the "medicine" or public "health" continues telling women to decrease fat intake for decreasing risk of breast cancer... Has anyone removed excess glucose from a human test body in order to see if it wasn't refined carbs afterall? The same thing goes for Diabetes related heart disease, since the numbers reflect that of Breast Cancer and still "they" are talking about saturated fat and cholesterol...

I'm sorry if it seems if I'm running on a tangent or raving... But, I believe I have a point: a society that has suddenly become extremely dependent upon refined carbs (especially economically from both sides: very lucrative and very inexpensive), like an alcoholic or a co-dependent family member, will not allow itself to truly consider refined carbs as an issue, even if it is killing the loved-ones, draining the family bank account and destroying the community... not even a supposedly un-biased scientific community... I remember talking with a J-Poucher who complained about severe issues of Pouchitis, but wasn't willing to remove alcohol from their periods of rest and "relaxation"...
Hi Sharon, nice to hear from you again. I was surprised that I could eat pineapple and papayas, dairy and who knows how many other things that made life virtually impossible and the running to the bathroom etc... Yesterday my wife prepared a beef "goulash"-like stew with leeks... I haven't had problems with them... Almost nothing I put in my mouth irritates me... not even dried chiles or fermented products. I swore that I couldn't ingest vinegars... But after reading so frequently on the Chris Kresser Paleo site about fermented vegetables and beans, for improved gut health (he's actually writing to the IBDs and those with SIBO), I decided to prepare my very own Kimchi and was surprised that I experience neither good nor bad, as if it was just an innocuous food to enjoy...

As for falling off the wagon... fortunately I'm not planning a return to New York City where you find baked goods from every country in the world that bakes with wheat flour at hand's reach... Here in Mexico the best wheat flour products are flour tortillas, a very European sourdough or non sourdough bread called Birote only found here in Guadalajara, a Cornish English inspired pastry called Pastes (pronounced Pasties), some wonderful Mexican Cookies and pastries uniquely Mexican and wonderful with a few cups of dark roasted black coffee and nothing else... I used to recreate gourmet pizzas and Mediterranean pastas or Hot Italian sandwiches etc in my kitchen. But, feeling nothing stressful within is worth the restraint. Walking on the streets of NYC would be trial by fire and would rather not go there...

On a slightly different note, my wife and I went to the Kitchen Aid store here inquiring about their meat grinding accessory, since we decided to refrain from buying grain fed/finished beef and began venturing into the vast farmland outside of Guadalajara for pasture grazed beef, which is high in Vitamin A and Omega 3, yet is much tougher than grain fed beef... We have a high-quality Kitchen Aid mixer that we don't use now that we don't bake, but can use it for its accessories. In the store I noticed a dry grinder accessory and learned that a diabetic woman here in Guadalajara is grinding dry garbanzo beans for flour she uses instead of wheat... The attachment is a bit expensive, but I believe it could be an interesting experiment... like creating bean flour too... Since it is a dry grinder, you can't grind nuts or seeds in it due to their oils...

Ross
Hi Grace B,

Have you tried ground flax seeds? If not, I would recommend buying them whole and grinding them in a Magic Bullet, Nutri Bullet or Vitamix Blender and Mixing one or two tablespoons in a large glass of water... I enjoy it alone or with the juice of one lime and occasionally with 1 or 2 teaspoons of sugar (only if I put lime juice. But, usually I include the lime without the sugar). As for grape juice... I would avoid it due to the added sugar. Another thing that helps me when I experience blockages or irritations is eating a whole apple... Aside from ground flaxseeds that I would recommend for the essential oils (Omega 3); up to 5+ tablespoons per day (don't buy it ground since it will be spoiled), apples were a miracle discovery that temporarilly removed all pouchitis issues, especially eating an apple right before going to sleep. If I'm correct it's about the pectin... You eat the apple and during the night it pushes everything through without irritation. You awaken in the morning, go to the bathroom and there are the complete apple bits and you totally relieved, especially since you didn't spend the night running to the bathroom without any relief...

Oh, and before I forget, visit Fire Island for me this coming summer... Although I live in Mexico, near Puerto Vallarta, I haven't experienced more beautiful beaches than in Fire Island... a true paradise. I camped a week at Watch Hill just after that horrible Hurricane in 1991... I'm sure you remember it... The following weekend we (my girlfriend and I ate long-necked clams out in Montauk or Sag Harbour and I became horribly ill... what a night! A few years later I would eat long-necked clams again in Camden Maine and repeated the horrible experience. Needless to say, I stay away from clams...

Ross
Ross,
A lot of traditional North African dishes are made out of various ground bean flours...Garbanzo bean, Fava beans and many others...they even do ground lentils (full of iron!).
They make a sort of pan bread using the flour, eggs and salt along with baking soda.
As for the vinager based or pickeled veggies and foods...I did lots of them.
There is an interesting recipe of pickled lemons (use small, young ones). You insize them on 2 sides, rub salt into them and then fill a jar with them, add salt & boiling water. Seal bottles and flip them.
You are supposed to flip them once a week and in 6 weeks the lemons are done...pickled. You then use them when you bake meats and fowl. They use olives with the lemons. makes for succulent dishes.
I make all of my own salad dressing out of either lemon or vinager and cold pressed olive oil. Much healthier & cheaper than the bottled kind and no artificial preservatives either (those are the real killer for me).
Hope that you stay well and happy
Nice to hear that you are doing so well
Sharon
Hi Sharon, I have a bunch of North African and Middle Eastern cookbooks. I'll look into them to see if they offer recipes for bean flours etc. I do have a recipe for the pickled lemons. If I'm correct, they are very important in Moroccan cuisine. I noticed them in Arab markets in NYC. But, imagine they were very expensive. Although I've cooked a lot of international cuisine over the past 25 years and some very complex/time consumptive recipes, such as Moroccan Chicken Pie (Bisteeya), Baklava, Thai and Indian Curries, Iranian Koreshes or Mexican Moles, with other things such as pickled Lemons etc, I've found myself very lazy... The Kimchi is wonderful. Although I believe Mexico cultivates a lot of real Lemons, it is very difficult to come upon them here. In fact, the Spanish or Mexican name for Lemon is "Lime" (Limon). What you would think they would call limes (lima), is actually a sweet lemon... Occasionally I find unripened lemons in the farmers markets and jump on them, since they are higher in nutrients than limes. You can tell when they are lemons, although green, because they are elongated and with a nipple... But, they don't become yellow, since they were picked too early. I won't have much time for experimenting in the kitchen until February. So, we'll have to wait for entering into pickling lemons and other interesting projects I may have been too lazy to do before, especially grinding beans into flour... If I'm correct, all Asian Indian pastries are prepared with bean flour...

Today I prepared blueberry plantain pancakes for some friends... Did I mention these yesterday? The are flourless. For some reason or another the blended plantains create almost the same appearance and texture as traditional flour pancakes. You put the plantains, coconut oil, eggs, baking soda, salt and vanilla in the blender and blend until smooth and that is the batter that you fry in the pan... So simple...


Thanks for reminding me of the Moroccan Lemons.

Ross
Thanks Ross I will try the apple. I am just nervous about eating it maybe I should put it in the bullet and blend with some coconut water. I do have a problem with constipation but I am going to try it tonight I will let you know how it works. I try not to eat anything after 8 because of bathroom issues, even though I have the problem of constipation I still get that urge during the night. After dinner I was taking a little miralax but my gastro told me to use milk of magnesia I am going to try that after dinner tonight. Thanks for all info I appreciate everyone's input, Every bit of info helps. It is nice to see all of the different foods that you are eating. Sounds good Good luck to you in your new endeavors and stay healthy Grace
Hi Sharon I was reading your post and didn't realize that lentils have loads of iron. Can you tell me what you make with grind lentils. I don't take iron pills because I suffer from constipation so this may be my alternative. I don't eat beef either it doesn't digest well with me. Scott also gave a suggestion and I do appreciate every bit of info I get. I went to health food store to buy floravital iron I did but is very expensive to be on long time regimen. I do buy it occasionally. I do take vitamins but I would rather get them from food. Thanks for any recipe you can give me. Be healthy Grace
Grace, I've had strictures, and a whole apple has blocked me in the past. I'd be quite careful with that. Remove the skin at least, if you try it. I'm very careful these days in regards to foods that don't break down easily. Pulverizing it in a blender might be a better option.

Milk of Mag is my go to for thinning things, because it's a nonstimulant. Sometimes I just take Mag Ox (OTC Magnesium vitamins) which work, too. Magnesium pulls fluid into the bowel, hence a more liquid stool.
Grace,
I agree with Rachel on the apple...Try blending it first...still get all of the goodies like the pectin but much lower risk of blockages.
Lentils are used in so many dishes...did you know that there are 3 different colours with 3 different qualities?
The 'nicest' are the orange ones but rather expensive, then golden or green...all are great, healthy and full of iron (eat with tomatoes or potatoes for a well balanced diet)...ground lentil flour can be turned into a sort of pancake or flatbread (fast & easy in a frypan or on a griddle)..But I make the old fashioned lentil soup with beef bones (all the goodness without the dangers of blockages).
I sauté the bones with tons of garlic, add thyme, paprika and laurel leaves (whole and throw out at the end of the cooking...Can cause major blockages if swallowed!) and then lentils then cover with boiling water and simmer.
Add the potatoes in cubes and/or spoonful of tomato paste...Simmer slowly.
Very, very yummy...more water makes it a soup, less makes it a stew. Sometimes I use a can of tomatoes in it to make it richer.
Loads of bioavailible iron too. (Be ware of gas, it could be problem for some of us).
Sharon
Constipation... that's why I hardly ever ate fruit, vegetables, nuts, seeds... for years, never apples... I also hated the skin. However...

Removing the wheat products, most industrial vegetable oils (in industrial I mean industrially fabricated, such as Mazola, Canola... non-virgin olive oils... and the such. Udo Erasmus explains extremely clearly the issue in his book "Fats that Heal; Fats that kill"), and most other refined carbs along with potatoes and most corn products I removed the inflamation that causes the blockage.

When you remove the skin of an apple, you remove most of the nutrients. So, if you don't want to eat the apple straight, blending it makes a lot of sense... if you don't have problems with those textures...

We are "special" people with extremely unique experiences, and the J-Pouch specialists and the Colitis, IBS, Crohns and FAP/Gardners "experts" don't live with these experiences, and being hard working human beings pressed for time, they don't have the time, energy or money for truly understanding what happens with the patient who had their colon and rectum removed etc. It is up to each of us to try and think "out of the box" or backwards and forwards, turning what we were told to believe or what we were told is normal or healthy on its head and start looking at things from a different perspective. Sometimes easy responses or easy fixes (represented greatly by the Pharmaceutical Industry and Modern Occidental Medicine) create much less recovery or much slower understanding of the situation.

If most of the problem with modern 20th/21st century chronic illness is related to inflamation, then maybe we should consider best what causes inflamation and what the inflamation causes.

"Itis". Do you know what that signifies? Inflamation. Pouchitis, Colitis, Duodenitis, Gastritis, Esophagitis... The inflamation of the brain is... Meningitis; "an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges."

So, imagine the J-Pouch or the Small Intestine inflamed and then imagine ruffage or large inflexible particles, such as nuts or seeds or broccoli etc passing through narrowed inflamed passageways, especially if those passageways have billions of folds or tentacles (cilia) that jut out towards the center of the passageway (if you don't suffer from Celiac Disease)... Now, imagine those passageways uninflamed...

Think about it. Why would we have problems with blockage when healthy people with colons and rectums don't? Where is the blockage occurring? In the J-Pouch? or in the Small Intestine? They have Small Intestines too... And, the J-Pouch is an increased reservoir replacing the rectum... our colectomies removed transit time and distance or space for creating risks for blockage or constipation... We don't have that reservoir (colon) for slowing things down and removing excess water. We shouldn't be the constipated ones...

or maybe we should turn the issue on its head and ask what it is about our illnesses/syndromes that causes the blockage in the first place... It isn't the natural and healthy produce we place in our mouths... Absolutely illogical. Although I imagine most of us have spent years blaming suffering on Lettuce, Spinach, Cabbage, Mushrooms, Broccoli, Cauliflower, Carrots, Beets, Kale, Swiss Chard, sweet potatoes, potatoes, winter squash, nopales (cactus paddles; which is ironic, since they are the #1 vegetable in the world for decreasing inflamation), Nuts, Seeds, Pineapple, Bananas, Papaya, non-squeezed oranges/Grapefruits, guavas, (I just named most of what caused me horrible bathroom problems for the past 11 years... which includes horribly embarassing night-time "incontinence"; when you actually manage to enter REM sleep after spending how much time in the bathroom straining, wishing you could pull out with a hook what is there telling you you must run to the bathroom every 5-10 minutes and then seemingly laughing in your face..., and either the liquid passing around the blockage and staining the sheets and irritating your skin... or maybe something "relaxed" and you awaken "in the process..." your "significant other" sleeping unperturbed alongside your "mess", your momentary sleep destroyed at 4am...)

This is NOT a joke. I'm NOT an outsider preaching to you.

No one truly shares their horrible experience with others (in order for others to know that they are not the only ones living these VERY PERSONAL difficulties. Afterall that is what these groups are for; support, increased understanding...), not even on the J-Pouch communities... (only surgeries and setbacks; it's difficult to mention constipation--we hear the snickering towards the back of the 4th grade classroom if you know what I mean)...

We've lived our lives as outsiders with our experiences... although it is not our fault, we suffer horrible taboos... What men talk about J-Pouch-caused sexual dysfunctions? Incontinence? What is worse to share with the ONLY PEOPLE IN THE WORLD WHO COULD POSSIBLY UNDERSTAND US and what we are experiencing...? But we don't go there. We can talk to doctors about this. Women don't remove their blouses and brazieres in public. But, if the person who will do the mamograph suddenly appears to be a "strange" man, they can become topless... I run shirtless in the city park (for Vitamin D) and people look at me strange. The children yell to their parents, "LOOK there's a man running naked in the park!" although I'm running with shorts... And I feel bad. And I feel bad when those shorts slip down a little bit and show a bit of my hip or upper buttocks... But, in the radiology room I quickly learn to not worry about the fact that the hospital gown is slightly open in back showing off almost everything, especially since they made me lay down on my stomach... We can tell these things to the doctors, since we believe they understand and because we believe they've heard and seen it all. But they are humans who have NOT experienced what we experience. And, until one truly experiences what we experience profoundly and possibly on a constant basis and truly what worries and irritates us, "they don't know NOTHIN'"...

But, I have stumbled across something... And I am sleeping through the night NO MATTER WHAT TIME I ATE (and I eat a lot and I often eat an hour or maximally 2 hours before I go to sleep)... And, I've stopped defocating in the bed... And I can eat almost all fruits, vegetables, nuts, seeds, cooked or raw etc without suffering as I had... And I don't take anti-inflamatories or metamucil or milk of magnesia or or or...

Ross
Last edited by RJG-Ross
I have been told, by my GI and CRS, that over time, the mucosa of the J pouch does turn more "colonic."

My GI has said that the pathologist will read biopsies on "old" pouches (not old patients, old pouches), as "colon." I can't point to it quickly, but I have read some studies about gene mutations in pouches. They change over time.

Stands to reason if that is the case, more water IS absorbed, and things can get thicker. Our outlet area (anal area) is not as flexible or large in diameter as a "regular" person's whose never had rectal/anal surgery (according to my surgeon). That's just the truth. The small intestine in a normal anatomy person's body does not fully break down things like skins, etc., either. Even certain things don't break down in the colon (ie. mushrooms, corn), however, their rectum/anus can stretch more to allow the undigested pieces the ability to pass. Ours sometime cannot. Also, our sphincters do take a little hit because of the perianal manipulation and suturing/stapling.

That's where my strictures and blockages have happened. Down low.

Others who have issues higher are often related to scar tissue, not necessarily inflammation. Our insides do not sit where nature intended them to sit. I've not had bowel issues due to scar tissue, but I've had reproductive issues because of the scar tissue entangling my ovaries and adhering them to places they're not meant to be. Can happen with bowel, only, too, and cause issues with blockages.

I, too, sleep through the night. Always have, after about the first year, unless I eat indiscriminantly/late, then I might get up once. I go 4-6x a day. I ate ANYTHING I wanted for 20 years, nothing gave me major issues. Only really in the last 2ish years have I had to edit more, because of my lower anastomosis issues and perianal fistula.

It is also interesting to me that pouchitis issues are nearly the exclusive problem of those with IBD vs familial polyposis patients. As if our genetics with inflammation cannot let go. I've been spared those issues for the most part, but the times I've gotten it were usually related to increased sugar intake (like around Christmas, when I ate too many cookies!). I do think refined foods are not the way to go, for sure. Also, years ago I went to olive oil, butter, and coconut oil as my fat sources. I never bought into the low fat hoopla. Perhaps that has helped me be more consistent over the years.

I'm glad you found something that works for you, though, and truly it might help others. I just wanted to point out some things about us that do make us different; our insides are not normal, and you really can't compare our small bowels with a normal person's anymore because of the manipulations we've gone through.
Thanks to all for all input. That's what I love about all of you. I am going to try the apple but pulverized I am a little to nervous about chewing. I don't normally eat anything raw unless I put it in blender. I would also like to try lentil pancakes. I do sometimes make a soup with lentils for my family but If I eat a bowl it just does not agree with me so maybe by putting it in a pancake it would be better. The plantain pancake sounds good to. So thank you all again and I will let you know how I do Stay healthy Grace
Rachel, I perfectly understand about everything you said. I also use olive oil and coconut oil. You are very fortunate that you were able to have much success with j-pouch I hope that you can get back to that. I know that sugar is the culprit to pouchitis. you are right Christmas is going to be hard. I am usually good about sugar intake but I still get pouchitis I can't figure it out but I do have to say that going off gluten has helped a little . Like I said I try to stay off gluten most of the time but every so often I do go off. I also have strictures around the bowl which makes it even more difficult. I hope that everything goes well with you and everyone else that suffers with this awful condition. Grace

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