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hey everyone,

Glad to see this incredible community of strong people exist. I'm a new j-poucher, a little over a month post op. Been doing well with recovery and BM's so far. I was wondering if the community can give me some tips for living with a J-pouch. Specifically:

I noticed a lot of people on this forum take metamucil. When would be the ideal time to take it? i.e immediately before a meal? immediately after a meal? I know its going to be different for everyone, but would like to try some things that have worked for some people.

The first couple weeks weren't as bad, but I've been getting really bad itching near the anus opening. I know its still early and my skin is getting used to BM's again, but are there any recommendations with dealing with butt itch?

Also, i'm not much of a drinker but I do like to enjoy 1-2 drinks very rarely, when on vacation, or celebrating an occasion. I know alcohol is probably off limits for the most part, but if there would be something to drink, what would be the type of drink that wouldnt cause much aftermath? i.e white wine, or a specific cocktail?

Any insight in general is much appreciated, thank you so much!

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@snash1108 posted:
I noticed a lot of people on this forum take metamucil. When would be the ideal time to take it? i.e immediately before a meal? immediately after a meal? I know its going to be different for everyone, but would like to try some things that have worked for some people.

This is from Metamucil's website:


Any time of day is appropriate to take Metamucil as long as an adequate intake of fluids (at least 240 mL of water or liquid per serving) is consumed. We recommend taking Metamucil three times per day at mealtimes as a convenient way to get the benefits of Metamucil. However, if you are taking Metamucil to help to temporarily suppress appetite you should take it before eating.Bulk-forming fibres like psyllium husk, may affect how well medicines work. Take this product at least 2 hours before or after medicines."

Many posters here take it before meals but I always thought that kind of kills one's appetite a little bit. Traditionally I take it at bedtime and wash down with a huge mug of herbal tea.

Last edited by CTBarrister

Welcome Snash1108!

A quick response here:

I eat Metamucil wafers as a mid morning snack daily.

I use a sensitive skin wipe after all BM’s to make sure it’s all clean down there  If needed I use A &D ointment for itch or irritation.

I am able to drink wine, red or white, without any problems. No more than 2 small glasses at a time.

Wishing you all the best!

The purpose of psyllium for J-pouchers is to bulk up the stool. I find it works best if taken with meals, so the residue doesn’t emerge as an overly loose BM. I take it before breakfast and dinner, but I want my appetite suppressed a bit. If you’d prefer to gain weight then after meals is probably the better choice.

Itching at the outlet can come from irritation or from fungal growth. I’d suggest a bidet attachment for your toilet - there are inexpensive ones that work fine, and there are also fancy ones with heated water, heated seats, and air dryers. In any case it’s important to keep the area protected and dry to inhibit fungal growth (athlete’s butt?). If you aren’t using a barrier cream after each BM now might be a good time to start - I did this religiously for a year or two after surgery. Simple zinc oxide works fine, and some people prefer fancier stuff, like Calmoseptine.

In addition to what Scott mentioned, there are various anti-fungal creams that can be used to control the itching, if it is in fact fungal.  I once got a prescription for one called ketoconazole cream:

Another option, for non-fungal itching, is to use zinc oxide combined with an over the counter steroid cream that is for itching.  Like Cortizone 10:

Dermatologists typically scrape the skin in the area that is itching and can determine by microscopic analysis (in less than 30 seconds) whether it is fungal or not.

I have lately been plagued by small, red itchy patches of skin on my upper thighs.  These were determined to be non-fungal swaths of eczema.  The cause is unknown.

Last edited by CTBarrister

Hi Snash,

I am about 18 months in. Typically when I have looser BMs I don’t suffer butt irritation/itch after I clean thoroughly with a baby wipe.

However, when I have more firmer stools the residue left behind leaves me with intense itching. The only relief is to sit on my bidet and let the spray wash away that residue.

I am fortunate to have a built in one with hot and cold water, but a portable add on to existing toilet would have worked also.

Last edited by New577

Hi, Snash! I have had my J pouch for 41 years and the first few months, burning and itching made me miserable. I soon realized that the tiniest secretion could cause irritation, so I tucked a small cotton ball at the opening of the anus. That collects any seepage, sweat or moisture before it gets on the skin. I haven’t had an issue with my skin since 1981. I hope this little tip helps you.

Bidet is a must - portable type squeeze bottle works while planning for an installed option.  And I alway end with alcohol free witch hazel. Just a bit on a few squares of paper.  Seems to clean, moisturize, soothe itch.  Dries quickly. I found it very helpful to clean Calmoseptine off gently which was otherwise hard to remove.  I use Thayers brand.

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