I am 3 weeks post take down. Does anyone have any top tips for pouch training?

I find it very uncomfortable to hold on going to the loo which I am told you are meant to do in order to stretch out the pouch to increase it's capacity thereby reducing frequency.

Many thanks

I always went when I got the signal to go. I never held it to increase capacity; those were not directions given to me. Do what's comfortable with you.

Sue

I've heard different views on that .....like ,it can stretch TOO much, and then there's the fecal stasis thing that if you hold it , it has more time to grow bad bacteria. Personally, I never tried to train it, just emptied as needed (or convenient).
LoriP

I went when I needed to go at first, too. Then I ventured out to short trips by the second week home, and especially the third week. Being away from home, I held things in longer out of necessity and never had a leak or accident. Just start venturing out on short trips (if you're off the pain meds, that is - don't drive if you are) and things should work themselves out.

I didn't have anything stronger than tylenol at home (the pain meds made me sick) so I was able to drive my kids to school, visit them to have lunch with them, etc, sooner. Then I'd grocery shop (not carrying anything more than 10 pounds), etc, so the trips gradually got longer. I returned to work after four weeks post td and was fine.

It's been six years since my takedown but I don't remember having any unusual urgency after takedown. Like Suebear I just used the toilet when the urge hit. Actually, it wasn't that often and it didn't just "hit". It was a gradual feeling of needing to empty and I had to learn to read the signals. They are different from when we had a colon. All in all, it worked out just fine. If I was near a toilet, I went. If I wasn't, I waited.

Thanks to you all for your comments. I was given some very clear instruction on pouch traiing, even a leaflet.

The leaflet recommends that you gradually, over a period of weeks or months (say 3 months) hang on going and increase the gaps between BM's by 15 mins and work up to 4 hour intervals.

I think I will gently follow the instructions for a while to help increase the pouch capacity and train the nerves that triger the feeling to go.

Fenners,

I was given very similar instructions regarding the training of the pouch. I was told this type of "training" will result in the pouch growing/expanding and better adapting to its fecal storage function. I found that the training did help in my case, and over the course of time it was easier to control. However, as noted by LoriP and some others on this Board, there is a concern that the pouch may expand too much, with the possible result that there could be problems emptying the pouch if that happens. I am not sure if the over-expansion of the pouch is due to this "training", or is something that would inevitably happen over the course of time in certain individuals anyway, regardless of the "training". I am inclined to believe that it's likely the latter. In any event, I have had my J pouch for 16 years and the pouch functionality has been essentially the same the last 15 years. I did initially have more frequency and looser, more acidic stools immediately after takedown, the latter resulting in temporary butt burn, but that died down over time.

Fenners, I would also suggest being attentive to your hydration and sodium/potassium intake in the early stages of having a J pouch. I can tell you from personal experience that a sodium overdose is possible if you overdo it with foods high in sodium. I also experienced some low potassium levels pre-takedown, and was careful to make sure I ate bananas and other potassium rich foods post-takedown. Hydration is the most important thing as you are very prone to dehydration especially right after takedown.

This message has been edited. Last edited by: DJBHusky,

I was told to try to wait 15 minutes, then increase from there after a time. I can now wait about an hour. it takes time. Your pouch is still new. Hang in there.

I was instructed to hold things as long as I was not unconfortable. It really doesn't take long for the pouch to learn it's new job.

Don't stress and don't hold things too long because as mentioned by LoriP, it gives the bad bacteria a better chance to grow.

All,

Thanks again for your responses. Very useful advice plus the details around sodium intake and such.