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I typically take lomotil 3x a day and immodium 1x or 2x a day, and when necessary I'll take a little more of each. With that, I'll have about 3-8 bowel movements, I think most commonly about 4-5, in a day. I've been away from this message board for a while, but I'm under the impression that a lot of j-pouchers don't take either of these medications regularly, and yet go 4-6 times a day. Does that sound accurate? Is my j-pouch less effective? Before surgery I was told that I could expect to go 4-6 times a day with the j-pouch, but they said I wouldn't need to be on medication anymore. I'm just wondering because I could not live without taking these meds, and before my surgeries, I was led to believe I wouldn't need to take any meds anymore.

P.S. I'm 2 years post-takedown, and things have been pretty steady for about a year and a half.
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Right from the beginning I have never used immodium. I really didn't need it. I was also dealing with an anal stricture for the first year so I needed my stool looser so I could pass it easier. I usually use the bathroom about 4 to 6x a day (sometimes more depending on what I eat). My takedown was almost two years ago.

Have you tried to go without them? If you give it enough time, your body may adjust to not needing them. Im a believer in the fact that your body adjusts. It may take some time and patience but I think it can.
Last edited by mgmt10
Once again, this becomes a very individual thing. Some of us never use imodium, others take them around the clock.

I have never needed lomotil with the j-pouch. I have never used imodium on a regular basis. My surgeon didn't even want me using it for the 1st month because I had been prone to blockages. After that, he cleared me to take up to 8 a day, but I've only ever used them on an as-needed basis, such as when traveling, or on occasions where I do have very liquid output.

If you want to try tapering down from your imodium or lomotil, you could, and see what happens. Add probiotics and bulking foods to your diet, such as oatmeal, rice, bananas, etc.

That said, don't feel bad if you cannot get off the imodium. Many pouchers rely on it constantly. And if you're managing with it and your pouch is otherwise functioning well, then why make any drastic change?
I haven't taken any either. I've been doing great the last 12 yr's, infact I seem to forget I haven't a colon, most of the time. I take my trusty yogurt and a dab of psyillum each eve. and cereal in the morning with psyillum. When I tried immodium or lomitil I found it made my poop back up and liquid run out, not good.
I don't think that they are needed if you use something with metemucil in it and take it every day, faithfully.
I think this is just one of those things that has an individual variability. You cannot try to force your fucntion to follow someone else's, or assume that because it is different, that somehow your pouch is less successful. It may have something to do with your underlying IBD subtype, or you may even have IBS/IPS.

Sometimes I think that surgeons do a disservice by painting too rosy a picture, and causing you to think things are not going well, if the outcome is not perfect. I understand the desire to plant high hopes in their patients, but sometimes it just goes a bit too far.

For me, I needed the maximum Imodium for a couple years, and over time was able to reduce to 4 a day, and maintain a frequency of 6-8 times a day, and I sleep through the night. Periodically, I try to reduce further, but I don't care for the result. I have no side effects with Imodium, so for me, there is no issue in taking it.

Bottom line, I would not worry about it, and focus on having good function, unless it is important to you to not take any medications. Go ahead and try to taper off them, but don't beat yourself up if you can't.

Jan Smiler
I used Immodium on-and-off during the first few months, but not regulary since (though I do carry some with me most of the time "just in case"). I do take Metamucil twice per day; once one I get up and once before bed. I average 4-5 times/day, depending upon my schedule (meetings, exercise, kid's activities, etc). Echoing others, it's a lifelong process of adjustment and re-adjustment. No big deal, just part of joy of having a jpouch. :-) Prayers & Best Wishes, Steve
I took alot of immodium and lomotil too. But i was still having leakage problems especially at work when i was active. I hurt so back from butt burn during working hours when i couldnt get to the bathroom to wipe off, so one day I just about had it, i was going back to the bag. But i didnt give up i decided to start all over with the meds and what to eat. So i quit all the meds, now everything is working the way it should be, hardly any leakage and can control it better. Forgot to mention I am 1 1/2 years post takedown.So basically what i am saying is try to go off the meds and see how it helps, you can always go back on if needed.
I've had Lomotil and Immodium by the truckload, tried several times over the years but never made any difference, so I take Padadeine Forte, it really helps, plus I need the pain relief, unfortuntely it has caused some liver damage, so was dramatically cut back, liver function improved but bowel function went haywire, now trying to find the middle ground. Its whatever works best for you.
I too did not like the way things like immodium & metamucil made me feel. And I agree with mgmt10. I think your body adjusts. And what works is different for each person. I go 5-8 a day. I eat a banana in the morning, take probiotics and take Levsin at night. All of these work for me. I could slow things down further by taking more probiotics or eating something like rice everyday, but when I do that , I have to strain and I don't want to do that, so I chose to go more often. If you feel good and the immodium works, stick with it. Don't know what the difference between lomotil and immodium is, but my surgeon told me I could take immodium the rest of my life and it wouldn't hurt a thing. Just didn't like it. You could try slowly substituting some of the meds for something more natural like rice or probiotics and if it didn't work, go back to meds. And my surgeon painted a pretty picture also. Don't know why they don't warn you about the possibility of meds for life or pouchitis. good luck

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