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Hi I don’t know if anyone has made this decision. I have been taking Lomotil and Imodium switching between the 2. I find that neither really helps me so I’ve decided to stop taking the both of them to see if it makes a difference. As I don’t think it works as far as a bowel slower. I do go between 5-7 times a day and sometimes more. I’ve yet to find anything that helps me and I am 1 yr in with Jpouch I still have leakage. I taking antibiotics and I don’t think leakage is from untreated Pouchitis. I am at my wits end. If anyone have any suggestions at all I will be grateful. I’ve tried Metamucil,  Citracel and the green  one can’t think of the name right now and they all give me anal pressure with cramping even though that’s happening even if I don’t take that stuff. Does anyone else get the anal pressure with stomach cramping and urge to go to th bathroom?

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Hi. Sorry to hear of your troubles. Here are a few ideas:

- If it's pouchitis that didn't resolve with Cipro, you could try the VSL3 probiotic powder and also using Rowasa enemas. That worked for me when I had mild pouchitis. (I can't take Cipro because I get such bad side effects.)

- Metamucil has a fiber cookie that is both tasty and, I think, more effective than the powder. At least, it is for me. The chocolate flavor ones are great.

- Going cold turkey off immodium if you've been taking it for years, like some of us, can actually cause you to go through some mild withdrawal symptoms. It's odd but no doctor I've spoken with knows about it but I've found tales of it online and I definitely accidentally put myself through it. So taper off, if you've been on it for a while.

- The pain/pressure-- I get this too sometimes though it's not bad. In the beginning after my take down it was unbearable. I actually went to get acupuncture to help treat the nerves of my coccyx area. It helped a lot. But it wasn't pouchitis then; it was something having to do with the surgery recovery, I'm pretty sure.

- I had some leakage in the first year and it's gradually got better and stopped. Things really do continue to get better even after the first year. Hang in there.


For some people carbs promote pouchitis (I haven’t noticed this effect). Starchy carbs digest directly to sugars, so they are nutritionally nearly identical, though some starches increase blood sugar a bit more slowly. The mechanical (stool thickening) effect is also a factor, though I prefer to handle that independently with psyllium.

Yes, meat and veggies, cheese.  I pretty much do a keto lifestyle.  I also have celiac so have been gluten free for 15 years.  The gf products added 50 pounds to my small frame, so I needed to lose weight as well.  I do fine with this eating pattern, most of the time.  All carbs turn to sugar which is highly inflammatory.  I know they tell you the pastas, rices, breads are easily digestible and help with the pouch, and for some people that may be true, but I have not had pouchitis since stopping all carbs.  

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