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My husband had his take-down surgery 08/21/2013. He's still having trouble with frequency and consistency. Currently taking 1 Imodium 4 times a day (just increased from 3) and Citrucel in a small amount of water 2 - 3 times a day. He has lately been taking the Imodium and Citrucel together... is this ok? He goes to the bathroom anywhere between 10 and 17 times per 24 hr period (sometimes more, rarely less), it's about 50/50 watery and thicker. Also, how long should he wait to drink water before and after taking Imodium & Citrucel? We're having a hard time finding the magic combination to help regulate him somewhat. He's eating bananas, fiber cereal and other bulking foods. Just curious what works for others. Any help or input is appreciated!
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It is not good to eat fiber foods this soon, they are not the same as Citrucel. He can take up to 8 Imodium daily. I took Metamucil 3 times a day and Imodium 4 times a day and had a lot of BM's but not that many. Had he tried Metamucil? I'm assuming Citrucel works better. I used Metamucil clear capsules so I didn't have to swallow the gook and could easily swallow them with the minimal amount of water. I took them before I ate and drank water after I ate. You might have him ask his doctor for a prescription for Loperamide, which is Imodium in capsule form. I like it better as it acts faster so I can tell if I need more. I use to end up taking too much Imodium sometimes before and he doesn't want to do that either.

Bagels and pasta are good foods to thicken things up too. I was told to eat white breads etc. and not to eat fiber in the beginning. The Metamucil is to suck up the water that the colon is no longer there to take out of our system. Eating fiber will move things along faster and make him go more often.

Good Luck
How much fluid is taking in a day? One thing I noticed was before I even think of drinking anything.. I must eat something to absorb it... If I drink fluids with my meals.. very watery consistency... I eat then I drink.. I also take citricul w/ water twice a day... Once in the morning and once after my last meal. Immodium you can take up to 8x a day w/ or w/o water (your choice). Immodium wasn't working for me, so I was prescribed lomotil and it helps with consistency for the most part and if I'm having a real bad day... My surgeon said it would be ok to take a few Immodiums with it.. and when I mix the two I have no problems whatsoever. It might be worth a shot to ask about lomitil. I had my takedown on 8/01/13 and believe me I understand and frequency and even night time leakages. But I have noticed the last two weeks have been great as far as these problems go. Maybe I'm finally over the hump as they say. Keep moving forward, it will get better soon enough.
Thanks so much for the help...

We've been kind of confused on good fiber/bad fiber. Oatmeal, vegetables and fruit are probably all too much? He was taking Metamucil but it seemed to cause more gas than Citrucel. He is taking prescription Imodium (Loperamide) capsules, he opens them and usually takes it with a spoon full of applesauce or yogurt. Is Loperamide different from Lomotil? Does it make a difference if he takes it 30 mins vs right before eating? I'll let him know to lay off the fiber, stick with white bread/pasta type foods and wait a while after eating before drinking.

He's usually able to get his 64 ounces in, as recommended by his dr. The challenge is eating small, frequent meals and drinking enough... without drinking too close to eating...

Recently he just hasn't been feeling too well, not sure if it's one of the many bugs going around or what. He's been having night sweats too, which we're hoping isn't related to the abscess he had after surgery. He recently started taking an antidepressant, which has a common side effect of sweating. It's just so hard to know what to worry about and what's considered normal... especially since his surgeon is in Minnesota and we're in Michigan.

Thank you for your reply's, we really appreciate the support.

Glad you're doing better Manny! You're posts have been helpful since you two are in the same time frame of recovery.

Take care and thanks again!
I recommend a food diary to measure transit time.
Here's why; jpouchers were always recommending oatmeal and applesauce as good thickening foods that also had a longer transit time. However in me, those foods had the opposite effect and caused me to be in the bathroom more frequently. We are not all the same, even though we had the same surgery. I'm sure your husband would be a lot more comfortable with a lower frequency. Have him write down what he eats and at what times. This will help him to tailor his early recovery diet to something that is manageable. Note that for the vast majority of us sugar will make things looser. And that includes fruit juices. So steer clear of sweetened foods and beverages if needed. Another thing to try is eliminating the heavy carb diet he appears to be on and go with more protein. All those carbs could add to more gas too.

It's really trial and error, and very individual, which is why a food log is helpful.

Sue Big Grin
Citrucel vs Metamucil both are fiber, whichever he likes best is the one to use. This one you swallow and it sops up water in our digestive tract. I suggested Metamucil caplets if he didn't want to drink whichever he uses in the smaller amount of water that we are to use. Stay with the Citrucel if he likes it best!

Loperamide/Imodium are the same and they are the same as Lomitol. These are anti diarrhea meds and are different than the above fibers. We don't mix these with foods but swallow with water. If someone just uses once a day it's usually before bed so they hopefully will not have to get up during the night. Use whichever he likes best.

Salad is more of what I call roughage than fiber and in my case goes straight through me literally, If in a restaurant I would be to the restroom before the dessert course, sorry if TMI. Veggies, depending on how well cooked are somewhat better. Oatmeal may or may not work for some in soping up water vs causing food to exit more quickly.There are 2 kinds of food fiber like Scott discusses.

I hope I've helped clarify better. Sorry about my first post. Some of us were taken back as our doctors never told us to open up or sqash or anti diarrhea medications.

I've had my pouch 3 years now and only use Loperamide as try to get everything I need from food otherwise. I used Metamucil a long time after take down.
Would just add that you might want to do a week's experiment replacing bread, pasta and wheat based starches with white rice for 2 reasons. White rice (I eat sushi rice) might be one of the best thickening foods out there. Second reason is that the gluten in wheat is irritating to some systems. That seems to be the case for me, and I never ever had a problem with it before. Once I was advised by a nutritionist to do so, I switched starches and saw a big improvement - went from misery to days of hope. (I also got rid of lactose, garlic, onion and other foods high in FODMAPs, according to the low-FODMAP diet out of Monash University in Australia). For breakfast I started eating cream of rice (orange box) made with coconut milk (good source of potassium, calcium), mashed banana, cinnamon and now adding puréed blueberries or raspberries.) Sauteed polenta (corn-meal based) has also been a good alternate starch, as are regular potatoes. To get more veggies ive been making small pots of cooked veggies with chicken broth (made without garlic and onion) and pureeing it, eating as a soup with parmesean cheese. Not too much but enough to feel like im not completely deprived of nutrients. And I agree with the protein comment. It's sometimes hard to keep up with always having prepared meats in the fridge, so just stocked up on canned chicken from trader joes. And I try to keep a batch of hard boiled eggs in the fridge when I need a protein snack but have no time to cook. I tied Imodium and other things but felt it was causing constipation. I might need to experiment again, but found white rice to be very helpful in those roughest of rough early days. Good luck!
Excellent... thanks so much for taking the time to respond. We're going use everyone's tips and try the one week experiment. Ideally he'd rather find a diet that works for him and not have to be so dependent on Imodium and Citrucel, although we know that may not be the case. Even so, Imodium and Citrucel are far better alternatives than Humira, Remicade, Prednisone... etc.
He'll get through this... you're help and support is greatly appreciated!

Thanks again!
Everyone is different. When I had my takedown, no one (not surgerons nor GI docs) instructed me to take fiber (Citrucel, Metamucil) etc. I took Immodium (still do). I also control the fluid intake- avoid adding sugar/sweet/salts to your fluids as this will only make you go more. Just my experience, but I would cut out the fiber for several days, and use only pure water- no sodas, Gatorade, coffee, etc and see how you do. Patience is the virtue- its takes a lONG time for things to settle down. For me, it's been years (takedown in 2007), so its a journey; no quick fixes.

Hang in there and good luck,


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