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Hi All. This is my first post. After reading some topics I am keen to join in! I am 57yr old female. Had high dysplasia 6cm tumour removed from sigmoid colon. The ileostomy done 17 May 2016 and takedown 13 Sep 2016, 9 days ago. I understood from my surgeon that he removed the rectum, some lymph glands, and a third of large intestine, and formed the J-Pouch from remaining large intestine. I have read a lot about pouchitis and want to find out if having the pouch constructed from large intestine tissue instead of small intestine tissue (as some have had) makes any difference? In my mind it would as function of large intestine (mainly fluid absorption) is different to small intestine (mainly nutrient absorption).  Any opinions or experiences? 

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Pouchitis can certainly develop in a colonic J-pouch. On the other hand, pouchitis doesn't trouble everyone, and in most cases it's easily treated. There are lots of differences between colonic and ileal J-pouches, but what will matter most is an uneventful adaptation period (which you're just starting) and satisfactory pooping (in terms of frequency, urgency, and comfort). In all likelihood you'll do just fine.

The pouch is constructed from the end of the pipe, in your case probably the end of the transverse colon or the beginning of the descending colon.

Thanks so much for reply. I am still in the early days learning! My other question is about diet. I had severe constipation in the hospital, with first BM 7 days after takedown. And then only with help from enemas. I am now at home 2 days and have lots of wind and some overflow, but BM's are not happening. Hospital dietician advised low fibre and low residue diet, but I am tempted to eat some raw veg or some fibre to promote BM's. Or, would this irritate the new j-pouch in its early days? I have read so much about pouchitis, it has me worried about what I eat. I know we are all different, but is there any general guidance about diet in week 1 and 2 post takedown?

Yes there are guidelines.  I just googled something like what to eat after j-pouch surgery and found it under the j-pouch group site.  My surgeon also gave me information on low residue diet which I followed for the first 2-3 weeks after takedown.  I am also new to this, 6 weeks post takedown, also on the older side of things, almost 62 female.  I am now adding different food items to my diet, but also include some from low residue/low fiber as well.  So far, my biggest issue has been coffee so I tend to drink chai tea instead (I was never much of a coffee drinker anyway).  I also occasionally take Immodium, but from what you are saying, not needed in your case.  Good luck!  Lots of good info. on this site.  I come to it often.

 

One source of constipation after surgery is pain medication. Opiates are extremely constipating. If you haven't weaned off of them yet it's best to do so as early as you can. Plenty of water, or even white grape juice may help. Please don't worry about pouchitis at this point. Your diet should focus on resuming normal operation, not preventing a hypothetical problem. 

Scott and CBT23, thanks your advice is realistic and reassuring. I am drinking 1.5 to 2 litres fluids a day, mostly water with some pure apple juice for flavour. My addiction is freshly ground coffee, but I only drink 1-2 cups a day. CBT23 - what was your issue with coffee - did it cause problems?

I am now NOT going to worry about pouchitis, sanity (Scott) has prevailed! I am going to stick to the low fibre/residue as per dietician.  I guess my chilli beans and veg yesterday was a biiig mistake! So back to staples butternut and mash! I stopped painkillers in hospital as heard they cause constipation, and also not taking non-inflammatories either as they cause stomach problems. Going cold turkey, but happier to deal with pain and discomfort than taking meds which only help superficially. But am still taking oral laxatives prescribed by surgeon, which have helped moderately, but I think also the source of major wind and cramp and odour (added was the chilli veg & beans culprit). I actually slept in the spare room last night to save my husband from the onslaught! I don't think not taking the laxative is an option, as only 2 BM's in last 10 days with the laxatives, I shudder to think my state without them!. 

Whew, quite difficult to know what to do and what to take, apart from dealing with the actual surgery recovery. still in pain and walking like a zombie ! Hoping it will all settle down and I get to know what to eat and what BM's to expect. I must say - I am longing for a good old one time dump to bring relief. But alas, am only managing pencil like droppings, pre-empted by much urgency, and then presenting only a disappointing few pellets. And then back again to the toilet a few minutes later with repeat. Cleaning and applying zinc each time. I am reassured by this site as reading that most probably will settle down eventually. Y'all have a good week coming, and thanks for your feedback. I really appreciate this site and the feedback.

I've had an ileal j-pouch for about 8 years due to Ulcerative Colitis. I take psyllium husk powder and VSL#3DS twice a day for regularity and to maintain intestinal bacteria. For occasional constipation I eat about 6-8 boiled prunes (prune juice works too) and if that doesn't work I take a couple of Senna pills. However, I recommend talking with your Dr. before doing any of this (except maybe the prunes) since it is so soon after your surgery. If I have any kind of problems, a diet of white rice (cooked very moist) and apple sauce and a protein drink for 2-3 days usually helps.

Any kind of beans are bad news for me! On the other hand I love freshly brewed coffee and it ruins my day if I don't have a cup in the morning. I think it effects some j-pouchers more than others.

Good luck!

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