The Trials and Tribulations of Clean Eating for a JPoucher

It's likely the non-soluble fiber from the fruits, veggies, and seeds. I love fruits and veggies, but really have to limit them.

However, watery, frequent BMs, and difficulty emptying are also a sign of pouchitis. I would suggest stepping back from the fruits and veggies and seeds for a couple days and see if there is a shift back to normal. If not, could be pouchitis, and antibiotics will help clear up quickly.

Additionally, your BM schedule is almost exactly like mine. I don't go a ton during the day, but always need to use the bathroom a lot in the evening. I do deal with chronic pouchitis, but what has helped a lot with the evening BMs is taking an Immodium plus anti-gas (simethicone) around 3 pm. This makes the evening so much better for me.

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Additionally, your BM schedule is almost exactly like mine. I don't go a ton during the day, but always need to use the bathroom a lot in the evening. I do deal with chronic pouchitis, but what has helped a lot with the evening BMs is taking an Immodium plus anti-gas (simethicone) around 3 pm. This makes the evening so much better for me.

oh my gosh me too, that sounds exactly like my schedule, and i just discovered taking an Immodium with Simethicone. I havent tried taking at 3, i normally do it right before dinner but am def going to give your way a try!

That schedule seriously is very similiar except lately i have been having to get up twice int he wee hours of the morning. like 3am and 5:45am like clockwork. this all started after an obstruction landed me in the hospital and they had to do a scope. prior to that i had nights where i was sleeping all the way through.

What can I substitute for the fruits and veggies that is not a processed food?

Would my body process better if it was in a smoothie form?

I will say my bm's do not smell nearly as bad with the clean eating. My bottom is taking a beating though.

After 3 years with my pouch, I still don't know how to manage fruits and veggies. I like them all in their raw form and don't experiment a ton with smoothies. Juice and sugars still get things moving very quickly. I still eat all of these things, but I just pay a price to do so with bathroom trips. I was dealing with obstructions and recovery all December so all of these foods were mostly on my no-no list. I just started them up again a couple weeks ago and it's definitely adding to my frequency and watery BMs.

Its hard to really know what to recommend because there are several things you need to find out for sure. Are you intolerant of dairy products? Do you have fructose malabsorption? Are you allergic to eggs? Do peanuts bother your system? This is just for my system, but when I look at your diet, I have say "no eggs, no dairy, no peanuts, no bread or wheat products, no oranges, no yogurt,no apples, and definitely no fiber, or fiber vegetables. While your diet may be healthy, your system apparently doesn't like it very well, and it appears to me you are consuming several things that may need eliminated. Now you need to play detective to figure out what those things are. If you can, make some 24 hour homemade yogurt. That eliminates most all of the lactose, so maybe you can handle it better. For meals, some meat, or fish with white rice. (No brown or wild rice, as these don't digest as well) for snacks, stick to well ripened bananas. If a diet like this helps, stick to it for a while and then later on try some peanut butter, sunflower seeds, store bought yogurt etc, to see if you tolerate them ok. I assume you cut out the sugar, sodas, sweet stuff, since you didnt mention them. At least I hope you did. Also, no margerine, stick to butter. And for cooking oil, my preference is lard, but coconut or olive oil is ok. No soy, corn, or canola oils. I have found soups with lots of ginger in them is helpful also. I am a big tea and coffee fan, but found out I do better drinking plain, filtered water.

I agree….I think an elimination diet is the only way to discover if the foods you are eating are causing you distress. Plain chicken with white rice will be your staple for a while and then you can slowly add in other items.
It seems you are taking in a whole lot of fibre. My dietician in the hospital said that the only way to take fibre out of fruits and veggies is to JUICE them. When you make smoothies the fibre is not broken down and the fruits and veggies have the same amount of non-soluble fibre in them than eating them whole.
Your bm schedule is making me jealous. I have been up for 1 hour and I have been to the loo 4 times. It will slow down as the day grows longer but after dinner I will be back to the loo every 45 minutes or so for a couple of hours.

For one thing the whey protein shake probably contains an artificial sweetener... Most do. Also whey in general has a tendency to cause gas and GI distress even in people with colons, and you're eating a lot of it. I would swap it out for a whole food with a similar nutrient profile (like sliced chicken breast or tuna packed in water), and if you're really married to the idea of drinking protein shakes, re-introduce them slowly (ie drink a small portion one day, instead of going from zero to two full shakes).

The whole seeds and nuts as snacks can be hard to digest and possibly causing irritation on their way out.

I totally understand the impulse to overhaul your diet and do everything "correct" right now, but it's probably better to swap things out one a time so you can tell what is irritating and what isn't. I know there are some veggies that increase my frequency a lot (spinach, summer squash) and others that I've found to have no ill effects (carrots and winter squash, so far). Once you've experimented enough to have a repertoire of "clean" foods that are easy to digest, you'll have better luck sticking to a "clean" diet.

Good luck!

I appreciate all of the responses. These damn pouches make us work a little more that we would like.

After I recovered from the surgeries, I was so excited to be able to eat the wings, pizza, fried everything, etc that I've been on a 3 year unhealthy kick so this reaction to healthy foods has been disappointing.

As suggested, I will have to do trial and error to find out what is causing the increase in bm's. I think I mentioned it's very watery and when it gets like that it becomes more acidic which irritates my anus.

I also usually always sleep through the night and I've been getting up once or twice to go and even soiled my pants one night from the urgency. Not cool.

Thanks again. Onward and upward.

wow no question you have throughly laid it all out..and have gotten some suggestions..my instincts and own experience says you are on the right track with eating clean as you say but no doubt it is daunting to figure it all out..

first thought i had was check make sure you do not have pouchitis that an antibiotic could clear up possible..and if yes take antibiotic as prescribed then look at second thought i had.

second thought you are eating very close to a scd diet but if you follow that you will have better guidelines and more diversity in what you can eat..main ideas here with scd is we have probable issues with bacteria which can and probable causes most of the problems you may have..main thing however is eliminating all starchy carbs and simple sugar(they feed bad bacteria)..and anything processed..thus the protein drinks whey are a no no..by the way when i used them years ago they definitely were not good for my jpouch..

with a guide like above you can go from their..scd has receipes for almond bread and other goodies you can safely eat ..

meanwhile my history..colitus eventual jpouch since 06,diagnosed chronic pouchitis on antibiotics all the time,then diagnosed with small intestine bacteria as main problem..3 months ago went basically on scd diet and off all antibiotics.it eliminated my worse symptoms of going not feeling empty and severe pain in butt..and feeling of not emptying...

i must say however, i have not been that concerned about how b.m comes out or that in fact i too go more in evening as you and other members have noted and i do get up a few times middle of night..but no pain,bleeding..

again although eating clean you still eating starchy carbs and whey falls into category..i do eat face yoghurt as you and minor sugar in that seems ok..i eat fruit..allowed in scd..berries are good choice by the way,ripe bananas,apples,water melon..you do not need whey protein..eat chicken,turkey,fish and nuts give you plenty of protein..my personal finding peanuts do not work as well for me as ,almonds walnuts..and almond butter better than peanut butter i find...

samlc25...based on your last post about having an accident over night really makes me thing this is more a case of pouchitis than what you are eating. i still thing you need to look into elimination diet as everyone has suggested, but the nighttime accidents starting up when you've never had them before, is my #1 sign it is pouchitis and not something that i ate.

I agree with checking into pouchitis as a cause.

I'd suggest thinking of "clean eating" a bit more broadly. I'd specifically add two ideas:
1) although what's called "clean eating" is a good strategy for many people (particularly those with colons), it is essentially a marketing term. The use of the word "clean" in this instance is (IMO) manipulative and poorly descriptive of the diet.

2) Insoluble fiber is a big part of "clean eating," and it seems to be valuable for people with colons. Folks without colons seem to get much less value from it, if any, and it does some of us harm at fairly modest quantities. I think your diet should be based on what works for you, rather than a nutritional philosophy targeted at folks with colons.

Just my two cents...

I tend to agree with Scott. There's clean eating, that might be of greater benefit to those with colons, and then there's "low residue" which may be of more benefit those without.

Reading your post, what strikes is that there are several foods considered high roughage in your diet, which could be contributing to increased BMs and irritation/bleeding you are experiencing.

For me, the foods that immediately jump out as potentially problematic are the nuts and seeds. I'd eliminate those first. They are difficult to digest. Blueberries don't generally bother me, but if you are eating a lot of them, remember that they do have skins which may not break down well for you. In combination with the other roughage, that might be contributing to your issues. The rest of the foods don't strike me as particularly problematic, but everyone is different. I'd start by eliminating the nuts and seeds and then see how you do.

Best of luck!

I came on here searching for protein powder ideas for me that won't run right though me. I came across your post. Your eating is awesome.

I'm in the clean eating club as well, and after I read your post I knew exactly what you were going through. From my experience, it's the protein shakes causing your problems. Someone else may have suggested this so forgive me if you've already heard and tried. Cut them out for a week and see how you do. I have a VERY hard time with protein shakes. I can't seem to find any that agree with me. They do right tough me and send my system into a tail spin for the whole day. The nuts and seeds are most likely not helping either, but not everyone has issues with them like I do. I can't have an orange without fear of a painful evening.

If you've found one that agrees with you please please share lol.

So funny, I forgot writing the reply I wrote earlier in this thread... Nowadays I drink a protein shake a few times a week after I work out. BSN Syntha-6 is the brand I like, but that's really based on taste more than anything else. I don't have any problems with it from a pouch perspective.

My diet is high in fresh fruits and vegetables. Breakfast is plain yogurt with fruit, lunch is diced apple, banana, and orange with cottage cheese and nuts with dried fruit. Dinner is either a large salad, a vegetarian loaf, or a baked apple. My frequency is very high but this is the way I like to eat. Your bleeding is likely from the nuts, don't worry about it. The vessels in that area lie close to the surface and can be easily irritated.

Sue

Curious about Whey Protein powder. I've used Paleo Meal unsweetened (https://www.pureformulas.com/paleomeal-powder-drink-mix-vanilla-540g-by-designs-for-health.html) in my morning smoothie since my first surgery, with no ill effect...but there's also a product by the same producer called Pure Paleo Protein (https://www.pureformulas.com/purepaleo-protein-natural-vanilla-810-grams-by-designs-for-health.html?CUSTOMTRACKING=CUSTOMTRACKING&CAWELAID=530005240001091831&CAGPSPN=pla&catargetid=530005240002487138&cadevice=m&gclid=CLz7gd2d98ICFYoRMwodLEAAqA) that I bought by mistake as the packaging is similar and it doesn't sit well at all.

I used the whey protein chewable tablets for years...They tasted like strawberry milk shakes, and could pop 2 or 3 during a class with a bottle of water and have enough energy to finish my class without any problems...they did not effect my pouch like milk did.
Sharon