Just had takedown. SO MANY QUESTIONS!

Hi Roger, Im 5 weeks from takedown myself, and had a similar experience.  5 or 6 times a day without meds immediately after the operation, and i could pass gas and urinate standing up (2 concerns of guys with jpouch).   I had the wicked cramps and pains,  they persisted for a around 3 weeks and reduced dramatically one night.

Although I have (almost) no gas and the cramping is very manageable now,  I can no longer pass gas standing up and find it much easier to sit to pee.  Unsure why these issue crept up 1 month after the op and almost expect them to disappear again.

The point is, everything is still changing, and just because you interpret something as good, doesn't mean it is.  Technically 5 times a day right after operation could be considered constipation (you can have loose stools and still suffer constipation btw, its all about the straining).  its certain you are very inflamed at the moment, so you situation will change.  By all means take the positives (and it sounds like you are bang on track), but please dont be disappointed if things take what you interpret to be a step backwards.   Its just part of the process. 

Top tip is to be careful with the diet, and the gulping of any water.   Just be patient no matter how well you think you are doing, you gut will appreciate the heal time..   Keep food soft and on the allow list, drink fluids some distance from foods and avoid anything bad.  And walk a lot.  Personally i want to avoid immodium/lomotil as long as possible, let the body find its own rhythm before I start slowing it.  for the gas, try going on all fours on the stairs (head first, bum in the air)..  that should do the trick :-)

regarding pain killers, there was a recent discussion in another thread.   I personally didn't get prescribed pain killers on release from hospital (tbh I coulda used them).  One of the nurses told me only opiate based drugs would work and they slow the bowel if taken regularly and I didn't need that because of the inflammation, Im not sure this was unnecessary, most docs would prescribe pain relief (apparently).  If you need meds take it,  but if you can do without I think its sensible to try.   Perhaps just take pain relief in the evenings before bed so you can get some sleep?   As already mentioned, you may find coming off pain killers means slightly more bathroom trips (to manage discomfort if nothing else).  Again don't sweat about this.  Let your body settle.  If your dieting its bad to weigh yourself every day as gets demoralising and its the same with toilet vists etc post op.   Take a benchmark in a months time, I cant believe how far I have come.

Another thing I started early doors is probiotics..  I figured a new j-pouch wouldn't have an abundance of friendly bacteria, so I wanted to try and help it as much as possible.  I couldn't really afford VSL#3 though (the only one tested for J-pouch users), so started on the symprove.

Good luck buddy

Roger, I personally wouldn't use opiates like codeine for pain from cramping. I'd be concerned about the gut slowing making the problem worse.

I am only three weeks post op but I can testify that the gas and cramping pains are already better! It is so hard to strain and empty that pouch but right before the two week out period emptying the pouch and gas pain greatly decreased. It sounds like you are on a good track in the other ways!

I am not taking Imodium right now either, my surgeon wanted to wait a little while and let your body figure itself out first. 

It's hard to take it day by day, but I do hope that you will have some reliefs from the gas pains soon. The best thing I could do for the gas/cramping was take warm baths, it dulled the pain. 

Almost 4 mos. out and very little gas issues, sleeping through the night with the help of Immodium before bedtime, which I did not start until about 7-8 weeks from takedown.  It gets easier!  Nothing I can't handle and little to complain about!