Hey everyone,

I started seeing Dietician/nutrionist a few weeks ago. She has put be on a wheat, dairy, soy and raw foods free diet and wants me to eat smaller more fruequnt meals. She recommends gluten free breads that contain flax seeds. Are flax seeds or any seeds for that matter unsafe for someone with a colonic j-pouch? If they are, how so? Sometimes I think I can see them in my stool. I've been on this diet for 3 weeks now and feel slightly better. I feel a little more energetic, but don't think it's helping my butt issues too much. Thanks!

Seeds are fine with a colonic or ileal j-pouch. Just because you see them in your stool, it does not mean that there is any harm going on. Flax seeds are an excellent source of omega-3 fatty acids, as good as salmon, so thumbs up on that.

We wrongly assume that when we see things in our stool that appear the same as when we swallowed them, we are not getting any nutritive value from them. However, after churning around with stomach acid, enzymes, and the rest of our digestive juices through the 20 feet of small intestine, we get most of the nutrition out of the food. What we are seeing in the stool is the shells of the seeds (same thing with peas and corn), all plumped up from the moist environment.

It sounds like your nutritionist suspects you may have celiac disease, which is a gluten intolerance (found in wheat, barley, and rye). Dairy intolerance as we age is common, but it is really just the lactose we become intolerant to. I would hate for someone to completely remove dairy for a prolonged period unless they had a milk protein allergy. Same thing with the soy and raw foods. Hopefully, she is just suggesting this as a short term solution while you are recovering from your surgery, not for a life-long diet change. Is this a RD (registered dietician) or a nutritionist (no education or licensing required)?

The primary thing to focus on is how you feel, not what you see in the bowl!

Generally, for the recovery period following a j-pouch the focus is on avoiding foods that tend to be gas producing, irritating, or promoting diarrhea and focusing on foods that tend to reduce output and gas. Remember, that the needs for a colonic j-pouch will be less than those of an ileal j-pouch. Here is a good link, but it is specifically for the ileal j-pouch and it is unlikely that you would need a restrictive diet for any prolonged period
http://www.j-pouch.org/diet.html

Jan

Jan,

Thanks a bunch for your post. I tend to think that this dietician has a thing out for wheat and diary and recommends cutting them back for all of her patients. She is ok with me having whey protein, and ok'd yogurt if that goes ok. She wants me to stick to the gluten free diet for a few more weeks. I mainly went to her for my family's sake since they don't think I'm being proactive enough, but have been eating better since. I am more of the thought that what I eat doesn't matter too much as long as I keep things in moderation, that my problems are anotomy related. I tend to have several days of small BMs and then get backed up and eventually have a big painful series of BMs to empty. Perhaps I need dialation?

Oh yeah, you are just as likely to develop an anal stricture as those of us with an ileal j-pouch, so something to keep in mind. Plus, do not expect things to operate just the same as before. You had your rectum removed and the colon does not have the same musculature as the rectum. So it is very important to keep your stools soft. Gradually build up your fiber as tolerated. This includes both soluble and insoluble, so don't be too afraid of raw foods (except for meats, of course!).

Gluten intolerance is more prevalent than once thought, so if you notice a real difference by avoiding it, it makes sense.

Jan