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Hi all,



I'm posting to ask for advice (or even just to hear stories from others who have dealt with something similar.) I finished my surgeries in October 2019; it was a 3-step process for me, and at the time of surgery my UC had failed to respond to any meds and had advanced to a dangerous point. I'd also had C diff multiple times. I was malnourished, and I had just developed Toxic Megacolon. The colectomy was an emergency surgery (bc of the TMC) and then I went through the IPAA creation surgery, and finally--the takedown.

I had one bout of Cdiff in the pouch right after takedown, but other than that my pouch has been very healthy, and I feel great! I actually got pregnant naturally and had my daughter in November 2020! During the pregnancy, the pouch was fine, but I noticed that as the baby grew and the pouch got moved around inside, I had to be very careful with what I ate. Eating any fruits, veggies, nuts, etc. caused me to "leak," and it made pouch output very thin and liquidy.

However, at the time I got pregnant, I still had not really weaned off the bland post-surgery diet anyway, so I was eating very little fruits and vegetables at a time. I drank fruit/veggie smoothies during pregnancy and ate some things mashed or cooked very softly.

It was an easy, wonderful pregnancy and (c-section bc of the pouch) birth! I feel so lucky and happy about it. But I gained a lot of weight during the pregnancy (I blame my carb heavy diet.) I was underweight before, or very close to it, but I gained like 60lbs while pregnant. I'm 6 months postpartum now--and I have lost about 30-40lbs of what I gained. However, I lost most of that in the first few months. I haven't lost anything the past few months.

The gain wasn't too bad. I don't even mind keeping about 10lbs of the pregnancy weight as I probably needed it. BUT I hate how I look right now, and how I feel in clothes, so I really, really want to lose at least 10-15lbs of the 25 or so I have left to lose.

I love cooking! And the first thing I did was restructure my eating habits and focus on eating mostly veggies and fruits and good meats--whole foods. I still stay away from beans, seeds, and nuts because those cause problems for me. in large amounts. I really love and missed veggies (I literally could eat salad for every meal.) But after doing this "diet" for two weeks, I developed arthritis.

I used to have UC-related arthritis. It was an extraintestinal manifestation of my disease; it cropped up as the inflammation increased in my colon. This arthritis flare up was just like when I had UC. Same types of joints and presentation. I was worried it was a postpartum hormonal thing or pouchitis (although I didn't have any pain or leaking or anything from the pouch) but I also considered my new diet...so I stopped it. Back to my low-veggie diet.

And the arthritis disappeared! I ate a salad three or four meals in a row last week to test it--and AGAIN arthritis flare. It went away when I returned to my usual carb-y diet. My thought is the fiber causes mild inflammation/pouchitis, which in turn causes the arthritis.

It seems like most pouchers on here eat veggies no problem (and some even have problems with gluten or dairy, what have you) so I don't understand what is going on with me. I feel very defeated because not only can I not eat lots of veggies, which I love, but I also don't know how to approach dieting in a healthy way with this limitation. Right now I am trying to cut carbs...and also generally to cut calories, which I hate. I hate feeling hungry, and I don't think cutting calories is the best way to diet really. I walk almost every day for about an hour with my baby, and I am going to start trying online zumba work out videos too.

Has anyone else experienced this? Is it possible for my body to be intolerant to vegetables and fiber? What can I do to work around this? Does anyone have any diet tips?

**I can eat some veggies and fruits, but only in small amounts. I also seem to have less difficulty with them if they are cooked, mashed, or blended. But I kind of hate the idea of eating a baby food style vegetable diet for the rest of my life.

*** I breastfed my baby for the first 8 weeks, but my milk supply was low. I think it was a hydration issue, but I ultimately switched to formula because she needed more than I could supply. I lost a lot of weight while breastfeeding, but I have not lost nearly as much since quitting.



Thanks in advance for your help!

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@LizAdair

Hello,  you sound like your doing fantastic after this life altering surgery.
I find my pouch can not handle lots of fruits & veggies, very hard to cut carbs when it’s hard to eats lots of food that doesn’t like our pouch.
I found being on the weight watchers diet actually allows me the portions I need to lose weight and still eat what I want, not just veggies & fruit.
I do hope you find what works for your pouch, because all pouches seem to handle food differently.  

I eat any and all sorts of fruits and vegetables, without significant issue. Sure, some things cause frequency and diarrhea, but it is self limiting and I am OK with that. Most people who have inflammatory arthritis that responds to diet restrictions get relief by avoiding highly processed carbs and vegetables in the nightshade family.
https://www.medicalnewstoday.com/articles/320233

Who knows if this would be helpful to you? We are all different.

Jan

I agree - it sounds like you’re doing great figuring out what works for your arthritis and health concerns.

I can eat cooked veggies but raw seem to get to me- especially raw carrots and hearty veggies. I also find that I can do salad but only for lunch, if I do it for dinner it causes me too much gas and keeps me up with bathroom trips. No cabbage- way too gassy. So there are things I know I can and can’t have. I mostly just stay away from uncooked veggies, except cucumbers- yum!

I, too, had a baby via c-section two years ago and it was tough getting back on track. I also want to be a good example for her. She’s eating great now that she’s eating full meals (she’s two)..but I know as she gets older it will be tough to explain- mommy can’t eat this or that). I also have arthritis and recently diagnosed with drug induced lupus bc of the Humira I was on to treat the arthritis (it should go away now that I’ve stopped the Humira) so it’s been a ride!

Just keep on tracking what works for you. You’ll figure it out!

Last edited by Bubba1028

Hi, @LizAdair. This connection between salads and arthritis seems very unusual. Most people who discuss their ability to tolerate veggies are focused on bowel function and bathroom activity, and that advice isn’t really what you’re asking about. I’d be surprised if it’s really the fiber itself. Jan’s point that vegetables in the nightshade family can be problematic offers a strategy you might try: a vegetable-specific elimination diet. In your case you could test the hypothesis that this is vegetable-specific by adding back one vegetable at a time, and sticking with each long enough to assess your symptoms. Wouldn’t it be great if the problem were (for example) just tomatoes instead of all salads? I hope you can find a healthy diet that’s close to what you’re hoping for - maybe it just needs a few tweaks. Good luck!

Thanks, guys! Lots of things to think about now.

@Lauren Of Emerald City I hadn't considered my water intake being important for digestion of fiber, but of course that does make sense. I could be more hydrated, so I will try working on that.

@Jan Dollar Oddly enough, I really don't seem to have any issues with most carbs. But I 100% do notice that I do not digest tomatoes and peppers very well (which are in the nightshade family, right?) I have also noticed that overly fried/greasy foods and large amounts of chocolate seem to cause problems for me, though not specifically with arthritis.

I would hazard a guess that the uncooked lettuce, spinach, kale, greens in the salads are a big factor, just because I only noticed the arthritis flaring up after several days of eating salads for lunch and dinner + an array of other veggies and fruits during the day. (But I can eat a few servings sporadically throughout the day of most veggies and fruits w/o arthritis. Just not the salads.)

@Scott F I think you're right about the elimination diet! If I can narrow the issue down to only a few specific veggies and fruits then I could enjoy the others without fearing a flare. I guess that and more water will be my next move.

@Bubba1028 Congrats!! Wow, I love knowing other people with J-pouches have had babies and c-sections. I don't know what it is, but it feels so cool to know others have gone through all these similar experiences. Especially when my OB/nurses had never worked with a J-pouch mom before! I felt a little alone in it (though my OB really worked to educate himself and was very good.)

And that is exactly what I worry about! Part of my goal with the diet (besides the weight loss) was to start setting up our family with healthy eating habits. I love my parents, but I don't think I grew up in such a way that encouraged healthy eating. It is so important to set an example for my daughter (who just started 'solids' recently) but I worry a lot about how to encourage her to eat healthy foods when my diet is so restricted.

@ytcrockpot Thanks for commenting! Again, it just really makes me feel better to know I'm not the only one who struggles with veggies and fruits. I remember my Mom trying weight watchers when I was younger...but I don't know much about it. I'll have to investigate. Interestingly enough, I used to have problems with veggies and leaking and gas after eating them (right after surgery) but now all of that has gotten much better. That's why it was so frustrating to be hit by the arthritis; I thought I had finally gotten to the point of being able to eat them again! Also another weird note: I was able to eat fruits and veggies when I had UC without any "extra" problems...but I think my UC was just so bad all the time that any and every food caused me pain and urgency at that point, so I guess that may not mean anything.

@LizAdair posted:

Thanks, guys! Lots of things to think about now.

@Lauren Of Emerald City I hadn't considered my water intake being important for digestion of fiber, but of course that does make sense. I could be more hydrated, so I will try working on that.

@Jan Dollar Oddly enough, I really don't seem to have any issues with most carbs. But I 100% do notice that I do not digest tomatoes and peppers very well (which are in the nightshade family, right?) I have also noticed that overly fried/greasy foods and large amounts of chocolate seem to cause problems for me, though not specifically with arthritis.

I would hazard a guess that the uncooked lettuce, spinach, kale, greens in the salads are a big factor, just because I only noticed the arthritis flaring up after several days of eating salads for lunch and dinner + an array of other veggies and fruits during the day. (But I can eat a few servings sporadically throughout the day of most veggies and fruits w/o arthritis. Just not the salads.)

@Scott F I think you're right about the elimination diet! If I can narrow the issue down to only a few specific veggies and fruits then I could enjoy the others without fearing a flare. I guess that and more water will be my next move.

@Bubba1028 Congrats!! Wow, I love knowing other people with J-pouches have had babies and c-sections. I don't know what it is, but it feels so cool to know others have gone through all these similar experiences. Especially when my OB/nurses had never worked with a J-pouch mom before! I felt a little alone in it (though my OB really worked to educate himself and was very good.)

And that is exactly what I worry about! Part of my goal with the diet (besides the weight loss) was to start setting up our family with healthy eating habits. I love my parents, but I don't think I grew up in such a way that encouraged healthy eating. It is so important to set an example for my daughter (who just started 'solids' recently) but I worry a lot about how to encourage her to eat healthy foods when my diet is so restricted.

@ytcrockpot Thanks for commenting! Again, it just really makes me feel better to know I'm not the only one who struggles with veggies and fruits. I remember my Mom trying weight watchers when I was younger...but I don't know much about it. I'll have to investigate. Interestingly enough, I used to have problems with veggies and leaking and gas after eating them (right after surgery) but now all of that has gotten much better. That's why it was so frustrating to be hit by the arthritis; I thought I had finally gotten to the point of being able to eat them again! Also another weird note: I was able to eat fruits and veggies when I had UC without any "extra" problems...but I think my UC was just so bad all the time that any and every food caused me pain and urgency at that point, so I guess that may not mean anything.

Love the layout you did haha! Creative

And okay sounds great!!! Drink before, during, and after every meal and move around as well

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