Hello guys!

So basically on 17/01/2018 I had my ostomy bag removed and I started using my J-pouch.  At first it was difficult and i knew it would be but I was adapting and managing.

However,  this past month or so I feel like I am simply going back.  This is because on days like today I can’t manage to hold my poop and it very easily slips.  In the beginning it only hapened for the first week then I was controlling it.  Last time this happened I had to spend two whole weeks at home for my bowel to rest.  This happened maybe 4 weeks ago.  Today I feel like it’s going to happen again as I can’t hold my poop.   I am worried that it has been 10 months and this is still happening

Any advice?

I only take probiotics as medicine currently.


Original Post

Its completely my opinion but if you're very sure that its not pouchitis or any other major issue one that you can handle yourself only then try taking fiber supplements like pysillium husk, add easy to digest foods to your diet like bananas, oatmeals,brown breads, sweetpotatoes,brown rice,peanut butter, or anything that you'd think eases your motion. I am only 3 months out with takedown so I am no expert but when my poop's not under control I switch to my happy diet and in a day or 2 things sort out to normal. Also I workout 6 days a week thats improved my digestion and gas. Pressure of gas is another thing that makes it harder tp hold back. If these solutions dont work you can always go to the gastro and get prescription. 

Good Luck 🤞

I went through a really tough spell 2 years post surgery and my colon surgeon (after determining there was no pouchitis) prescribed Welchol, as a bile sequestrant. It's often used to lower cholesterol, as it  binds the amount of bile in stool. That bile after a colectomy has nowhere to go but out and it can create difficult diarrhea, leaking, oozing, burning etc. It was life changing for me. 

I eventually stopped taking it as things stabilized around year 3. Now at year 6, I still have good and bad weeks. I second the happy diet advice...it's really important to figure out a fall back eating plan that comforts and soothes your digestive system. 

Wish you well...hang in there! 

Bleeding has never been a symptom of Pouchitis. Not sure where you got that.  The main symptoms are incontinence, particularly at night, increased frequency of BMs, and increased liquidity of BMs. I also get a slight crampiness as it advances without treatment. 

You need to call your GI and get some antibiotics. Start with Cipro or Flagyl and go from there.

In all my years of pouchitis on and off, I never had bleeding. It isn’t that common, but it does happen if the pouch is really pissed off. Bleeding is more common if you have cuffitis to go with it... Anyway, bleeding is not a requirement for it to be pouchitis.

Pouchitis, on the other hand, is super common and is a possible cause of your symptoms. When the pouch acts up or the bowel is inflamed from something, it can’t absorb water (just like when you had colitis). You have looser stools with more volume, and it’s not easy to hold it in like it would be with a more formed stool. Ergo, runs and troubles. 

Pouchitis usually comes with cramping pain when you need to go, or tenesmus. It’s super unpleasant, and usually pretty clear to diagnose, if you have this... 

Some people improve greatly with probiotics—higher doses than on the bottle, and taken daily/multiple times daily. I was always able to stop my crazy bouts of pouchitis with probiotics.

Dietary modification if you notice triggers can help. Dairy, sugar substitutes, fruit juices, and other high osmotic loads can set you off. You can develop an imbalance of the small bowel bacterial flora that causes this as well. 

When that doesn’t work, antibiotics are a next step. Beware, though—Flagyl is horribly nauseating for some and can cause neuropathy. Cipro is associated with long term problems also. For short courses, they are probably worth it, but not always in the long term. That’s ignoring the problem of developing resistant flora, too. There is always rifaximin (Xifaxan), which doesn’t get absorbed into the body, and just kills off everything in the gut so you can repopulate it with better bugs. But these only work if you have SIBO or pouchitis.

If you don’t have crampy pain with your need to go, it may be something you’re eating, and not true pouchitis. Beware the GI who wants to scope first and ask questions later... I don’t know about you, but I’m getting tired of everyone wanting to stick things up there!!! 

Oh, and sometimes you’ll find that there’s a ‘magic food’ that helps the runs stop. Mine was fried rice. I never liked fried rice until I got it one day by mistake, and it halted my bout of post-pouch diarrhea... then it became my ‘rescue meal’ for whenever something else had thrown my gut off kilter. Very useful when traveling to have something reliable you know will help you get back to your baseline. I’m not saying it wasn’t bizarre that fried rice helped me—but who am I to argue with something that worked every time???

There is something else, by the way, that doesn’t get discussed much. It’s called irritable pouch syndrome, because it reminds people of IBS. No one knows what to do with it/about it. It’s when you don’t have pouchitis, so no crampy pain when the pouch fills up, but you are going all the time with urgency (that ‘right now’ feeling) despite the usual meds and a normal scope... it sucks, basically, because no one knows what to do for it right now.

Anyway, good luck, and I hope you get sorted out soon.

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