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18 replies

New J- pouch question

U UCWarrior2010Member
Hi,

Now that the obstruction is resolved I have a new question - It's been about ten days since my takedown (it was on Apr 9th) and I feel I am constipated. Initially, I was having very liquidy stools while I was still in the hospital and was on a liquid fit. But, since being on a soft diet the stools have thickened quite a bit and I am having trouble emptying the pouch. I am pooping small, pellet sized well formed stool and I have to strain to do so. Also I end up sitting a while on the pot to go each time. I am really worried about straining because I had a fissure earlie and I don't want it coming back. Anyway, does this sound normal or is something amiss? My diet right now is mostly GI soft which includes white bread, pasta, white rice, etc.
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mgmt10mgmt10Member
My only experience with straining after takedown was due a stricture at the anastomosis site that needed to be dilated. I had that same constipated feeling with lots of unproductive trips to the bathroom. My stool was never quite as formed as you are describing though so you could have a tough time passing due to that. But it is quite common right after takedown for scar tissue to form down there narrowing up the passage. You could try eating something that may "loosen" up your stool to see if that helps as an experiment. For me chocolate always gives me really loose stools. If it continues, definitely check in with your surgeon and tell him/her about it.
U UCWarrior2010Member
Thanks, Marianne and Scott!
Marianne - Wouldn't a stricture at the site of the anastomosis result in some sort of a blockage? I did have a partial blockage after my takedown but I think it has resolved now. I no longer feel bloated or nauseated after eating. What are some of the foods that might help "loosen" things? I had coffee today hoping that might help things loosen up. I will also pick up some chocolate today when I step out.

Scott - I drink a lot of water already but I will further increase the intake. It's not too bad yet, just a little uncomfortable and irritating. What other adjustments can I make?
Scott FScott FMember
Others here have much more experience with loosening methods, and hopefully will weigh in. Your diet sounds like it needs some ingredients less likely to turn into glue inside you. Add some other things in moderation, and see how you do: maybe grape or apple juice, heck, maybe a small salad, well chewed. Other folks can add to the list.
U UCWarrior2010Member
I have expanded my diet to include foods other than just breads and pastas but I am yet to try veggies or raw fruits. I recently had a partial obstruction and my surgeon had asked me to say away from certain veggies and fruits until I see him again on the 29th.

Things are a shade better but I am still having trouble totally emptying the pouch or emptying without straining. Everytime I go, I poop very little and have a constant pressure on my anus as if I have to go again. I hope this is just my pouch adjusting and things will et better with time.
U UCWarrior2010Member
I spoke to my surgeon today and he said that he had dilated me when he did the takedown (i.e., two weeks back) so he said to wait until Monday when I have my next appointment so see how things are. If things don't get better, he might check for a stricture again.

Scott - Are there any particular juices that I should consider drinking? I sometimes drink apple juice.
P PluotMember
Well, take this with a grain of salt since I don't even have the damn thing yet, but my output was uncomfortably thick with my end ileo so I supplemented with a cup of apple juice at every meal for the first couple weeks. Not so great for my blood sugar in the long run but that's what I needed to get a decent consistency because most of the post-op foods are thickeners. Give it a try?
A APMember
I had pouchitis for six months after take down. I ultimately think it was because I was constipated. I discovered psyllium fiber because someone on this site recommended it. I take it several times per day with a full glass of water. It has saved me. Everyone is different, so who knows, but it might be worth a try. I have been pouchitis and constipation free since getting started on it and it has been almost a year now. Every time I feel a little constipated or like my pouch is acting up, I up my dosage of fiber and things straighten out. Just wanted to share in case it might help.
U UCWarrior2010Member

Hi Jeff, 

I am sorry that you are going through this. I was having this issue a while back so I don't remember precisely what worked. But, yes, I did find relief. It's been four years since my JPouch surgery and things have been good for the most part. So, while I don't remember how exactly this issue was resolved in my case, I can tell you that this is a temporary hiccup. I'd say try some of the suggestions that have been offered here. For example, have apple juice with each meal. Even now if I have fruit juice, my stool tends to become less thick. So, this might do the trick. Wish I could be more helpful! Good luck. 

J JordySimoMember

I'm 3 months post-takedown and strain on the toilet, but I don't just sit down and strain really hard, it's more like a little push, but when the stool is passing, I naturally tense up. I've had no problems by doing this and my surgeon isn't concerned by it either. When I was taking 6 imodium tablets a day, the stool was really thick, resulting in formed pellet like stools. Now I've reduced it to 3 a day and also sip on apple juice through the day, it has loosened up and become easier to pass. I still get times when I think I'm finished on the toilet, go and sit down or walk for a little bit but then end up needing the toilet again. Hopefully this settles over time. 

I've found that bending forward when on the toilet, almost putting my head between my knees gets things moving a bit quicker and sometimes leaning backwards when sitting on the toilet as well. Try putting your feet on a small stool as well so that your knees are high, this can also help. I'm still adjusting and figuring things out too so you're not alone on this one! Haha.

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