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How long are you sitting for? Have you tried keeping your knees higher than normal while having a bowel movement?

Gas is the least likely thing to get stuck, but it can certainly back up. I often sit for 20 minutes just to make sure I am fully evacuated. Sometimes the gas takes its sweet time to finally get there but it does.

You may be experiencing pouchitis if you are feeling extremely gassy. You may also want to try and cut out anything that makes you gassy, sugar, carbonation etc.

I have that problem alot. I lay down on my stomach. Then, I take my hand and place my palm on my waist line. If it is still not working I push gently up on my abdomen. That, for me at least, relieves the gas. This might not be the best thing to do but it's what I have done for 10+ years. I hope you can get some relief from the gas pain. It's the one thing that always bothers me.

Last edited by Hoyt

Is it low in your pouch? Not up higher like an obstruction? Not being able to pass gas normally (on the toilet sitting) is my first sign that I am getting cuff or prolapse issues at my rectum Laying on my left side and waiting for the gas to shift usually works. If not, or if it lasts, it means I need prednisone. Another option if you aren't really able to empty your pouch normally is to ask about a catheter. I just got one on Dr Bo Shen's advice and tested it It worked great even though its not exactly pleasant. I didn't have any urge to go and still emptied A LOT. 

Since I wrote this, I've been able to pass gas three times. I'm afraid to soil myself so last night I put on a diaper. This morning I had to press really, really hard to get air out. I didn't soil my diaper but man, it was hard to push. I wonder why. I did the candle stick dilation my surgeon told me about and this makes me able to go better. I'm still learning everything with my j-pouch and I'm writing it down so I remember what helped for later. 

Try grape juice for blockage.  It has to be 100% grape juice.  I keep it on hand now always.  It’s something in the sugar that helps you go and pass gas.  But don’t drink a lot at one time.  Also laying on your left side helps me out a lot.  I take Levsin/SI for my gas everyday.  It has been my life saver for years now.  It just goes under your tongue.   Look into it.  It was my life saver.  Good luck.  Things do get easier.  

I'm halfway through my antibiotics and I'm not better. It's not that the noises bother me. Whenever I feel it moves inside it hurts. I was able to pass gas one time yesterday and that's it. I constantly have the feeling of being full and bloated. I'm nauseated by it (something anti nausea meds don't touch) I feel disgusted by the contents of my belly. It keeps moving and it's loud and it's painful. I can't deal with this.

People around me can hear it and they think it's just gas but it's a mix of gas stool and inflammation I think. I am so very embarrassed about it too

And the gas pain radiates to my shoulders and I can barely stand up or walk around in in so much pain. 

Last edited by Andrina

Have you been given prednisone for inflammation? It really sounds like something is obstructing your pouch in some way, either inflammation or a stricture/prolapse. Have you had a scope to look inside your pouch for structural issues? You might want to ask for a defecography study to see if you have trouble emptying your pouch correctly.

In the meantime, definitely get a catheter if you are comfortable trying it. They suck but they are MUCH better than being in pain like you are describing. 

Marlen Ostomy Straight Catheter 30Fr15LMedium. And a 50-60 cc catheter tip syringe. Plus some surgical lube. You need the syringe to clean the catheter, if your stool is firm, or if you ate anything chunky. You can get the catheter from a medical supply store online and the syringe almost anywhere. As long as you don't jab it in and ignore your body, I don't think it can hurt you. My doctors told me to get one without any instructions  

I don't think so? Gas tends to move up in the pouch so maybe something is happening farther up and you can't push it down and out. Dilations didn't help my issue or at least not for long because my issue wasn't strictures. I don't think dilations will help if there is a ton of inflammation from straining either. I can't imagine doing one without anesthesia if you are already struggling! I had the needle knife procedure for two strictures (after I was perforated during a dilation) and banding to support some prolapses. Your gas issue sounds suspiciously like my prolapse issue. I could poop at least a little at a time but I couldn't pass gas. It was because straining deformed my pouch and kinked it so I could never empty it completely. 

But seriously, if you can't get something done soon, look into the catheter to help out until they can do something surgical to help you. I went from being on and off prednisone and on a liquid diet to being able to feel normal except for in the bathroom. After my banding, I can go normally but I still use the catheter to make sure I don't strain and to help me empty my pouch more completely at night (no trips to the bathroom at night now!). The catheter can keep you functional until you can address whatever is happening. You don't need a prescription for them unless you want to bill it to your insurance. 

I always try to go the easiest way first. I have had enough surgery. 

I would try lying in bed with something stuck in between there to absorb anything that comes out. Roll on one side then the other. The gas should move around also. When you feel like your ready, I lay on my right side hold my left leg up and can usually pass some gas. I hope this works for you!

@MetsFan posted:

I always try to go the easiest way first. I have had enough surgery. 

I would try lying in bed with something stuck in between there to absorb anything that comes out. Roll on one side then the other. The gas should move around also. When you feel like your ready, I lay on my right side hold my left leg up and can usually pass some gas. I hope this works for you!

Sounds like I have to be patient. I'm also afraid of pooping myself so I'm actually kinda holding back when not on the toilet and on the toilet I can't go. 

For the prolapse, it can be suspected by a specialist based on your symptoms and what they see when they scope you. They verify using a defecography study, where they fill you up with barium paste and have you try to poop it out while the radiologist records how it moves using x-rays. It wasn't fun but it wasn't painful. It was somewhat satisfying having visual evidence of what I felt was happening.

I did two procedures to resolve the prolapse but it was really not a big deal. I am not sure if anyone other than Bo Shen at Columbia does it but its a very quick procedure. You do a mild bowel prep, they sedate you (twilight because its not very painful), they do an endoscopy, and based on your defecography study they inject little bits of glucose into your prolapsed regions and place little rubber bands over the bumps that this makes. The bands come off after a day or two and you get little scars that support your pouch. I had minor discomfort and no bleeding or anything. I was able to eat normally that night and spend the next day sightseeing. 

I bought my catheter online from a medical supply company - no prescription needed. They are something like $10-20.00 each but rush shipping costs a lot Insurance might cover the catheters if you get a prescription but I didn't bother because most of the cost is shipping and insurance doesn't cover that. I will probably ask for a prescription now that I know using one helps so much and buy a case instead of just one.

For the catheter, theres not much to it. You can't really hurt yourself unless you are really rough but there is a BIG risk of a mess if you aren't careful. I get a large disposable plastic cup full of warm water, the syringe, my catheter, and some TP and stand over the toilet. You lube up the catheter and insert it as far as you can doing whatever wiggles you need to get it up there without discomfort (they are small but there are some edges). You will feel it hit the top area of your pouch. If you bear down any gas will come out. Stool will too if it's not too thick or if you haven't clogged the catheter with vegetables. I use the syringe to inject water if it's too thick or I suspect clogs. Be SUPER careful when you do this so you don't have any sort of spraying all over the floor... You can move the catheter up and down and rotate it if there are clogs and it helps. Repeat all of this until you feel comfortable and not much is coming out and then carefully remove the catheter and push water through it into the toilet to get it cleaned out. Then I just clean everything well with soap and hot water and store everything in the cup. 

 

I sure hope I don't have the prolapse. I would think that the xrays with gastrografin would have showed something. They were looking for blockages at that time but couldn't see any.

Small update for tonight. After my dilation I laid on my bed with a little bit of a blanket tucked underneath my belly and I was laying on it. I was afraid to push gas but I did and I didn't even soil myself. Pooping has been easier too since then. I guess I need to do the dilation even though I hate it but I can see that it helps. I wonder if the exit is too narrow for air bubbles to pass through. This would explain why I haven't passed gas for days if not weeks. No wonder I'm feeling so sick then. I haven't had the j-pouch for a full year yet and it's such a big learning curve. Thank you all for your advice and experiences and I'm sure I'll be back for more questions later. 

Last edited by Andrina

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