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I had the takedown surgery 8 mos ago in Jan 2012. I've had above average BM's per day and am taking codeine and lomotil to get through the day and night (somewhat). I had a pouchoscopy 3 weeks ago because the adjustment is taking longer than usual however the pouch looks good.

My surgeon says that I'm simply taking longer to adjust than normal. He doesn't know why but it will definitely get better with time.

Does anyone know how the jpouch adjusts? (I like to understand how things work.) My understanding is that the peristalsis in the pouch has to stop, the pouch has to physically expand, and that mentally one learns not to panic when there is an urge.

Is this correct? Are there any other changes going on? What else can be done to speed up the adjustment? (I'm aware of the dietary and fibre supplement suggestions.)

Thanks!
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Has your doctor ran blood and stool for infection/parasites? Sounds more like pouchitis then anything else. Have you ever been on Cipro and/or Flagyl? It's hard to say, everyone heals differently, but after eight months things should be settling down. Try thickening agents like mashed potatoes or bananas to bulk up your stool, and ak your doctor to run some lab work to help solve the problem, good luck, feel better soon!

Eric Eeker
quote:
My understanding is that the peristalsis in the pouch has to stop, the pouch has to physically expand, and that mentally one learns not to panic when there is an urge.


This is correct. I had problems with excessive motility in the 1st year but this settled down. Until it settled down I took bentyl, levsin, Donnatal, the anti-spasmodics. Eventually I did not need them.

The pouch also expands over time and this enables one to hold more stool for longer periods of time, based on the simple laws of physics.

How long this process takes varies by the person, but in my case I want to say it took up to a year.
I also like to know how things work. I'm a biologist, so I went the scientific route and started reading journal articles on the subject. The pouch itself, besides expanding, actually undergoes structural changes on the cellular level. The tissue of the pouch actually starts to take on the characteristics of colon tissue as time goes on. This process will, of course, take time (reconfiguring organs isn't a walk in the park) and everybody is different. The human body is capable of some pretty fantastic things, as long as it's given enough time to change and a good reason to do so.
quote:
My understanding is that the peristalsis in the pouch has to stop, the pouch has to physically expand, and that mentally one learns not to panic when there is an urge.


I asked this question regarding peristalsis in the pouch and was told it doesn't stop and can be quite "brisk". When you think about it, it doesn't seem possible that it can totally stop as it is connected to the rest of the intestines and peristalsis is a wave like action. I think the strength of peristaltic motion does vary from person to person. I read somewhere though that The pouch adjusts from having primarily an absorbtion function to primarily a storage function... for most people.

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