I had my take-down operation over 4 months ago, but I am still struggling with incontinence. I saw my surgeon almost 2 months ago and he said my sphincter tone is fine (both inner sphincter and external sphincter). He said it was strong enough to prevent incontinence. He said slowing my bowel down may help so he added 4 x 60mg of codeine per day to my 12 loperamide per day. This in fact caused my stool to become even more watery so I stopped the codeine and increased the loperamide to 16 per day, which was another option the surgeon gave me. My stools (poo) continued to be watery, so I reduced it to my previous 12 per day and now am on 10 per day. I take 5 before each of two meals, breakfast and lunch (midday). I used to eat a slice of bread and peanut butter in the evening, about 4 hours before bed, but it didn’t make much difference so I have stopped.
The surgeon put me on Cipro for 2 weeks before he saw me and he examined my pouch with a camera and said there was no inflammation, ruling out pouchitis. He said he would refer me for a manometry test to check my sphincter muscles. My nurse later requested a pouch scope. I am still waiting for these as they were put down as non-urgent, on the NHS.
I have been doing Kegel exercises since my operation and am trying now to squeeze as hard as I can to build up muscle strength, as of 4 days ago.
The stool just pushes through, however, especially when I walk. Wind often pushes it through.
I cannot understand why my muscles cannot hold the stool in if my surgeon said they have good muscle tone, enough to prevent incontinence. I have quite high frequency but often not a lot comes out. I can hold it in for a few hours but often go every hour or even more frequently if I feel burning.
My diet is quite bland: potatoes, fish, pasta, white bread, bananas, peanut butter, marmite. I also take a multivitamin with iron supplement. I avoid sugar. I am adding small amounts of vegetables just for a bit of variety, but no more than a desert spoon at a time.
My bowel is active on a night and usually empties by about midnight or in the small hours and I can then sleep properly.
I am wondering if my sphincters are damaged, or were cut too short during surgery, or whether they are simply weak. I had a bag for 5 years and my GP said my muscles will need strengthening because of that. Hence, I keep doing the Kegels.
Any advice would be appreciated.
Thanks for taking the time to read this.