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I often eat salads and like Scott I have no problems. Just remember that with insoluble fiber (lettuce, carrots, tomatoes, etc) you will see it pass. Don't be alarmed, it doesn't mean that you are not getting the nutrients from those foods. It's just that they don't completely breakdown. In a person with a colon they don't see the insoluble fiber because their stool is compacted. Your body is grabbing the vitamins and minerals out of these foods and what can't be completely broken down with digestion is passed through.

Sue Big Grin
I am curious to know what is meant when people say that certain foods that 'cause issues" for them. Is it a problem of blockage? Indigestion? Increased frequency? Anal irritation? Change in consistency?
I find that I'm still quite nervous about trying some foods. However, if the result is irritation or frequency then I would 'risk' it...I just really don't want to experience a blockage! I had blockages with the ileostomy but not j pouch.
That's a hard one to answer exactly.

I've been with a pouch for almost 24 years, and what irritated me in year one doesn't always irritate me now. Trial and error is essential, but also don't assume what bothers you year one will bother you year 20. Early on, I might get a bit irritated with tomato sauce, and now it doesn't really bother me.

In my case, I developed, after year 21 or so, some lower anastomosis issues with strictures, right now I'm ok, but I remain cautious with foods I don't break down well, like nuts, seeds, mushrooms, quinoa, raw carrots, corn... I either avoid them OR allow myself two or three bites. Like pumpkin seeds, I used to be able to eat a lot, now I'll allow myself maybe 10 seeds, and that's it. The first 20 years, I ate everything and anything.

My advice is start slow. Maybe have a salad only with lettuce. Then, next day add a few cucumber slices. Then add some shredded carrots. Have it as a side with your regular meal, and not a ginormous restaurant salad. See how it goes. And again, don't rule out foods after one trial, but if it bothers you, wait a month or two and then try again.
Because my three year experience with out of control ulcerative colitis, the past ten years plus with a J-pouch has seen me prefer crunchy salads to any other food! I can't seem to get enough of them. Fortunately, my J-pouch loves salads and so I visit a number of salad bars in my area to fill up on the ingredients I don't typically buy because I live alone and they spoil before I finish using them. I keep my own lettuce varieties but go to the best salad bars to purchase a little of this and a little of that to go into my salads. Fun for me!
Blockages are not (mostly) caused by food choices; they are usually caused by something narrowing or kinking the bowel, changing a wide-open tube into a smaller opening (or no opening at all). Since some foods are more likely to get trapped in a narrow channel, they can be thought of as blockage-causing foods, but you have to already be in trouble for them to get stuck. Folks living with strictures or especially troubleome adhesions may have to be quite cautious with what they eat, but most J-pouchers will never cause a blockage by choosing the wrong food.

More common, I think, is increased frequency, or changes in stool consistency based on food choices. Many of us don't care about that unless it affects urgency, continence, or sleep.
Last edited by Scott F
There's always a reason for bowel kinking, but that doesn't mean it's predictable. If it seems completely mysterious it's usually adhesions, and they usually do unkink on their own after making you sufficiently miserable. Adhesions can afflict anyone who's had abdominal surgery, not just J-pouchers.

I have some adhesions, noted on a subsequent unrelated surgery, but I've never had a blockage. I don't limit my diet other than a bit of moderation.
This is kind of a loaded question, as it's a highly individual thing. Many j-pouchers can tolerate lettuce in moderation, and yes, for the first 4 or 5 years post takedown, I ate salads all the time and didn't have any issues whatsover. Unfortunately over the last 1-2 years I've had increasing problems with adhesions, such that I've had to limit my intake of certain foods, lettuce in excess being one of them.

Basically, the bottom line is, YOU are the only person who can really decide whether or not you tolerate any food, and so what it comes down to is trial and error. Absolutely, go ahead and try lettuce (or anything else you might be a little worried about), in small quantities. If you have no issues, you can gradually up your intake of those foods.

It would of course be super easy if there was one single magical diet that all pouchers could follow, all of the time; unfortunately it doesn't work that way. Smiler

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