Hello all, I have had a j pouch since Sep 2015, no real problems until now. Suddenly this is week 4, I am passing no stool or gas, I went from at least 2 bowel movements a day with lots of gas to NOTHING. Of course this has caused a ton of discomfort and I can barely eat. I tried doing a enema once on week one and once on week 2 of this with no relief. Monday I had a abdominal x ray and it showed I was completely full of stool and gas. She is wanting me to do a colonoscopy prep but I have no colon and possibly go back to the colorectal surgeon for evaluation. Has anyone else had this happen? Any suggestions?

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I get constipated when I take up too many imodiums or rather I'd say more than 2 a day. So I take them very less now. The downside is I have 5-6 bms instead of 3-4 but on brighter side I can empty myself with ease. I still take the pill when I have to go on a trip, hiking or any event where access to a washroom is uncertain. If I still get constipated I drink milk with pysillium husk. Milk is a good laxative and adding the husk somewhat makes it better. I can clear up the entire day's output in 1-2 bms without having to push hard. 

Shoflo, I seem to have the same prob. I drink white grape juice if I can't go. Sometimes it brings on diarrhea, but at least it usually gets things going. It's at least worth a try. I know I can't drink the prep. I threw that up when I had a colon! Anyway, good luck. Let us know how things go.

It can be difficult to tell constipation from a partial bowel obstruction. In both cases drinking adequate water may help prevent or clear the event, but this can vary a lot. Soluble fiber can help prevent constipation (as long as there’s adequate water in the gut!), but it’s not going to do much for an obstruction. Laxatives of various types may help with constipation, after you’ve already made bricks, but they do tend to be targeted at the colon. Many will still work for a J-poucher, though. If the constipation is in (or near) the J-pouch a tap water enema may help clear it. You can use a Fleet enema bottle and replace the contents with warm water. Be careful of high-volume enemas, since you don’t have a high-volume colon.

The key ingredient in every case is water, though you don’t want to force it into a blocked gut.

Thanks, she called in the prep I used to drink while waiting on colon removal called Prepopick it's orange flavored and only two 5 ounce doses. I go back to see surgeon on Monday afternoon. I just pray it is something that can be easily corrected.

Prepopik is just a very high powered sodium based laxative which is designed to loosen you up and stimulate some very explosive bowel movements. You will after taking that laxative spend some time on your toilet giving birth to them.

More important is why you got so dehydrated and impacted in the first place. With a proper diet and proper hydration and as long as you are not wolfing down opioid pain meds, this shouldn’t happen. Good luck getting to the bottom of it.

Several different things can cause this. I hope you’re being given a customized prep for the pouchoscopy - I’d expect something like numerous small-volume tap water enemas rather than anything from above. Some of the potential causes aren’t visible on pouchoscopy. For example, a pouch prolapse is best diagnosed with defecography. An overly tight anal sphincter is diagnosed with anal manometry, though if you can’t pass a Fleet’s enema bottle, or your doctor can’t pass a scope then that says a lot. Some people accumulate solidified psyllium or stool in their pouches, which is more like constipation. A stricture should be visible on pouchoscopy, though a pouchogram might be more revealing.

Good luck!

Shoflo, my pouch was also full, as was the intestine above it. I was in the hospital when mine was found. I had  gone to the ER for a possible blockage. They admitted me and were going to do surgery to unblock me. My surgeon decided he didn't want to do emergency surgery on me, because he said I could lose my pouch.  So came the collaboration between the surgeon and GI doc. only what to do with me. It was a lot of hurry up and wait.  An Ng tube for five days, and lots of enemas and x-rays. Finally they did a pouchoscopie. Pouch was still full. They have a chopping and rinsing tool to get that out. Thank God. Mine ended up being  a stricture at the beginning of the pouch. It's was closed to the size of a pin head. The GI dialated it with balloon. I guess this is something I will have to go and get done periodically. I've increased the amount of liquids I drink to try and keep the stool pretty soft without being diarrhea. I also try to watch the amount of stool thickening food that I eat. I treat this as dealing with constipation. Lots of water, I drink grape juice or take miralax when I feel I'm getting blocked again. Im figuring as long as that is working I don't need to go get dialated again yet. I do still take Benefiber, so I don't have problems at night. It's a balancing act.  It's do able for me. Certainly better than having the pouch removed.  Good luck with the scope. Let us know what they come up with. Thanks

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