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I recently got rid of a bout of diarrhea (it lasted about one week), which I supposed was caused by magnesium, but not sure, if it was a simple case of pouchitis (I also took the standard two antbiotics to clear up it); this led me to change my diet as I don't like when my output is liquid and freqent (in this case about 8 times per day when my normality was 3-4), and added more consistently psyllium (not too much, about 1 times per day before a meal). My diet changed in a way I excluded gluten and lactose, and included lots of rice, a few of legumes and potatoes, meat, eggs, bananas and some pineapple (sometimes I also have other vegetables, cooked)

The result is:

 - stools are really good, most times well formed, sometimes more liquid

 - continence is very ok

 - less blood from hemorrhoid or fissure (don't know specifically) when straining (i still have to strain many times)

 - INCREASED frequency, now the median is 4 to 6

 - INCREASED discomfort before emptying, I usually wait for the pouch to be full before emptying, but before, I keep it very well, now I experience a significant amount of discomfort. The discomfort means feeling full, have some pain, and the pain often lasts also after emptying.


Note that I'm not sure I am completely free from pouchitis as the last blood work the CRP was 1 (max normal level 0,5) and the white cell count was 13.8 (max normal 11.5); I'm set for repeating the blood work at the end of the month to see how is going.


I'm not very happy as I'm not sure my new regime is really good for my pouch, I'm concerned I increased too much the fiber intake (not that before it was zero, but still less), I'm quite happy for my bowel movements which are nice, and in reality I'd like to avoid straining, and because I noticed that adding a small cucumber at dinner, the following morning I go very well without straining I'm considering to add more and more fiber, but, I'm not really sure, so I ask you a thought based on your experience. In the end my main concern is the pouch health so I'm looking for the best maintanence diet.

Last edited by Ikh
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Hi Scott, why you are saying so?

I empirically found that straining is troublesome as when I strain I lose blood, is there any other increased risk in it? (abdominal hernia, hemorroid, cuffitis, fissures, pouchitis, anal cancer, fistula and so on?)


In any case I find that I strain somehow 80% of the times, no matter how is it formed.

Scott, I think that the cause is mechanical / psycological: when I empty, I want to empty full, but the first "batch" is overwhelmed by the weight of what is above, so it goes out very well. When it remains something (that I definitely feel) I have to decide if keep it, or strain to expel it. And psycologically I always choose the latter as I like to be really empty. But this is the case, I already lose blood every single time I strain too much.

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