Is it normal?

hi all,

     5 days post takedown. Feel ok just wondering if anyone had this experience. I scoured the threads first and didnt really find anything specific. Toileting about 10x during the day so pretty happy w that but by the end of the day my anus is soooo sore and feels like I have a roll of quarters stuck up my butt ha. Not really any butt burn using wet wipes, calmoseptine, and hand held bidet (which i learned on here) On top of that i can only pass small amounts at a time before i have SEVERE tenesmus or almost like everything just closes off and have intense pressure at the anus. After about 1 second of passing stool everything locks up. Takes about 3-5 mins to resolve but even walking I can feel it pretty much all day. Gets pretty miserable by the evening. He did a flex sig and dilated a stricture during operation so im wondering if its that? Or maybe its all just normal for 5 days postop? Dont see any huge hemorrhoids or anything. Shouldnt be prolapsing or anything wouldnt think. Nonfevers or anything odd to suggest abscess. Put in a message to my surgeon who is great but wanted the experience of people who actually live with a jpouch. Experience is always the best teacher! Any thoughts appreciated! (Crossing fingers for normal) lol

Original Post

Hi Native, I'm sorry that you are having trouble. I did not have that feeling, and the only thing, since you didn't say there was any discharge, is that maybe you have a hemorrhoid. Probably to be safe, give the surgeon a call. Good luck, it sounds like you aren't doing to badly.

I guess it could be an anal fissure, though people usually describe that as sharp rather than “a roll of quarters.” Another possibility is that the sphincter is going into spasm, or simply not coordinating with you attempt to empty your pouch. Some of this could settle down on its own, but it might be worth trying an antispasmodic, like Bentyl or Levsin, to see if you get any relief.

Hemorrhoid was my first real guess with the way it feels thru the day but seems odd to be that intense and with the tenesmus. Scott I would figure a fissure to be more sharp and painful right? Thought about just grabbing some cortifoam or hydrocortisone prep just to try if surgeon agrees? Or see if he still thinks could be from stricture. Its an odd sensation but of course everything is odd when you havent pooped in 6 years lol thanks for the replies! The morning time is usually prett good but as the day wears on it worsens. Seems to be relieved some by warm water in the bidet bottle and sitting on a heating pad ha

figured I would fill in what the surgeon said in case this thread ever helps anyone ha. Said the way I describe it sounds like pouchitis. Increasing urgency and frequency, fullness and soreness with tenesmus. Wants to try a course of flagyl and call back if not improving in 48 hours in which case wants to see me in the office. To be continued.... ha

Hello, Native.  

Try using a sitz basin, and use the warmest water you can tolerate. A sitz bath will help heal your insides by encouraging blood flow to those wounded tissues, especially five days after takedown.  Warm water will also help relax your sphincter muscle. You can buy a sitz basin on Amazon or any specialty health equipment store, but it's probably cheaper on Amazon.  

I had the same experience as you very soon after my takedown. Each day brought a new issue, not so much a roll of quarters, more like a tennis ball!  A bidet, a sitz basin, and careful food choices helped me.  You would know if you have a fissure: each BM would feel like shards of glass or razor blades coming out of the back-end while tears come out of your eyeballs.

Thanks Winterberry, 

     Yea i use calmoaeptine and a bidet bottle each bowel movement. I put hot water in it every time i can get it hot before the urgency kicks in ha. Seems to help a little. Today has been a touch better but i guess i ought to start the antibiotics in case its a very early case of pouchitis. Im doing the low residue diet and been eating very bland so surely its not diet related im hoping. Do you remember the foods that helped you get thru it? 

Just an update in case someone finds the thread helpful. Surgeon said wouldnt expect the stricture I had to be an issue at least not directly after dilating and sigmoidoscopy 1 week ago though not totally out of the question of course. 2 days on flagyl now and coming into this morning is MUCH better so looks like could just be an immediate pouchitis flare (hope its not foreshadowing of future chronic issues). Also only ate crackers all day yesterday to keep stool consistent. Will try to add back in some more fiber restricted foods today but as of now at least I dont feel like I am about to birth a watermelon with each bm ha 

Hi Native, I am too 1 week post takedown. Had slimy output for a day post op . Once I started with solid foods on second day had bloating and gas with diaroehha . My stomach felt like a swollen ball. Couldn't breathe very easily. Things are getting back to normal now. Going for bathroom like 8 times a day. Yeah that something big is going to foush out is still there but this too is reducing hopefully it keeps getting beyter with time. My doctor gave me lactifiber it contains lacitol monohydrate and psyllium husk. I take 4 tsp wvery night just helps me sleep throughout with only one visit that too because I have to pee.


Raj thats awesome. Im around 10-15 per day now but I am up ALL night in the bathroom. Hopefully once im off the antibiotics the pouchitis will stay at bay. My surgeon also talked about maybe adding a fiber supp but after my 4 week checkup. I supposed I could try immodium at night but worried about backing up haha. Sounds like you are doing great for where we are. A few times with urgency and still feel a little strain to go but im sure it will all improve with time. I got no MAJOR complaints. I wish you well in your recovery my friend!

- Native

Hello, Native.

I'm sorry for the delay answering your question about what I ate after takedown. My first meal at home was a poached egg with white rice. I knew I needed the high protein and vitamin B the egg provided, and the carbohydrates from the rice to give me energy, and rice helped to thicken output. Breakfast everyday was peanut butter (100% peanut butter, no added sugar or salt) on toast or bagel, an egg, and tea. I tried to eat an egg every day for the protein and easy digestion.  Lunch was pasta with olive oil, salt and pepper, or store bought pesto. A piece of baked chicken for protein. No tomato sauces on the pasta in the early days because it is acidic and I was already burning. Dinner was always fish or beef or chicken with pasta or rice. Sometimes tofu. I ate a lot of protein.  Slowly I began adding steamed spinach, peeled and cooked zucchini, microwaved sweet potato drizzled with olive oil. I ate sweet potato because I think it is more nutritious than white potato. When you have high frequency, you lose a lot of nutrients so every meal has to count.  When I introduced vegetables again I always peeled the skin and cooked the veg really well. No raw vegetables, no skins, no salads, no nuts or seeds in those early days, and I avoid them now, too. I avoided fruit, but reintroduced them slowly (no skins).  Chew everything well so by the time it reaches your pouch it is dissolved.

I made weekly batches of chicken vegetable broth, and also made bone broth. Stored them in the fridge in Mason jars and drank one each day. I really believe the broth helped speed my recovery by keeping me hydrated and full of minerals, potassium, etc.  Drank a glass of water after every BM as a way to rehydrate.

Around the eighth month after takedown I was doing really well, no more burning, no more urgency or frequency, no real issues. I only needed two courses of Cipro in the first year, I think, and never used it again. I used Metamucil three or four times (doses), but didn't really need it because I was eating soft, bulking food. Yes, it was very tough in the early weeks, and each day brought a new problem and I feared it was the new normal, but it got better. I walked a few blocks every day for exercise, even when I wasn't feeling well and wanted to cry rather than walk. Food choices, using the bidet every time, baby Zincofax in early days, and light exercise. Now I sometimes forget I have a pouch. I hope it will be the same for you, in time.

Winterberry thank you for the detail! Some days I would welcome a little diarrhea haha my stool is always peanut butter consistency. I had an ileostomy for 6 years so I got used to drinking about 6-8 bottles of water a day and still do. Currently no immodium or metamucil but thinking of trying the immodium to maybe sleep a little at night. Thanks to all for the replies. We all appreciate it! Im hoping my eventual norm is "forgetting about having the pouch."  It is hard for so many of us who had UC Especially i think  because it is like reliving a nightmare at first ha

Update in case its helpful. Really not a lot of relief and still having some straining. More than I figured would be normal. Having to push pretty hard with each bm. Surgeon called me and said either he or my GI need to flex sig and see if the stricture is the issue to dilate if needed or what it looks like in there. So thats the next step. Said if bm are peanut butter consistency then maybe try half capful of miralax to loosen some but of course be careful. 

Wow, sorry to hear things are not getting better for you. To thin the thickness of stool, you can cut back on the white rice, pasta, potato's and like starches. I think alot of us use metamucil with good results. If you do have a stricture it's prob. best to have a more watery stool until the GI or surgeon can dilate if need be. Unfortunately for all of us, when the pouch is new it mostly trial and error until we find what works for us. Thanks for keeping us informed and good luck with pouch scope. Im so hoping they get you on the right track. Let us know what happens. 



My GI did a scope today. Pouch looks great, no pouchitis, no stricture. Said the cuff was just pretty inflamed and should calm down over time but is putting me on hydrocortisone supp for a week. Said maybe canasa after that if doesnt improve much but has been  improving over last couple days. Also recommended VSL #3 that I know quite a few folks on here use. Anyway just an update. Maybe I should have waited since its so early but that straining freaked me out a little ha. Thanks for all replies!

Thats great news. You should give yourself time. It was a big operation and you were on ileostomy for so long your muscles just need their time to adjust back to the new normal which they will eventually. Just stay away from the medical shit as you got the operation to get off them in the first place. If you visit a doctor he'll prescribe a medicine to ease you up else you wont find him usefull but you gotta know for yourself if its absolutely necessary ( just a thought XD ) . A probiotic tablet in a day is great if you like dairy and gluten and specially if you're putting on weight . It helps digest what you cant normally plus lesser bloating. If I eat my maintainence diet I'll just have pysillium husk and if I have to eat more to put back some weight I'll add in a VSL3# or Sporlac ds tablet.

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