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Just giving a quick update.... I'm never on these boards anymore because I am too busy living and loving life!!

I am four months out from my takedown after j-pouch surgery. The first month of that was spent in the hospital with complications, and I even had further complications once I returned home. (See my blog by clicking on the link in my signature for more details.) However, I have been living complication-free with my fully functioning j-pouch for at least two months now. Here is what I have been up to in those two months:
  • Returning to work as a high school teacher without any potty problems
  • Traveling near and far for recreation and visiting family
  • Social gatherings and events including drinking alcohol with no negative effects
  • Going out to eat at restaurants without hesitation
  • Learning to ride a motorcycle - just bought my first bike and am very excited about it
  • Working out and exercising again to regain my fitness
  • Meeting, dating, and falling in love with a man I believe to be my future husband (including a very wild and kinky sex life)

Although my bowel function is far from perfect, as you can see I have definitely been able to reclaim my life in a way I was not able to do with the unpredictable symptoms, drugs, and side-effects that came with severe ulcerative colitis... and I know it will only get better from here as my j-pouch continues to adapt and settle in. If any of you have any questions regarding the surgical process or life with a j-pouch, feel free to email me at the address listed on my profile.

Good luck to everyone, and take care!

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What do you mean by "going often"? Normal for healed j-pouchers is 5-8 times per day.

According to the manufacturer's website, here are the main ingredients of Ensure, in order: Water, Sugar, Corn Maltodextrin, Milk Protein Concentrate, Soy Oil, Soy Protein Isolate, Cocoa Powder (Processed with Alkali), Pea Protein Concentrate, Canola Oil.

Too much sugar (the first ingredient) is known to cause diarrhea even in people with healthy colons. "Milk Protein" probably refers to whey, which is a very fast-digesting protein and will likely cause added bathroom trips. (It does for me, anyway.) Cocoa Powder (a.k.a. chocolate) will definitely stimulate the bowels, causing additional bathroom trips as well. If I were you, I'd re-think the Ensure, as I don't think it's doing you any favors! If you're looking for a nutritional drink/shake with protein, I'd recommend one of the Odwalla protein shakes. You still have to watch out for the sugar, but at least it's from fruit, which is nutritious. In other words, don't live off of these types of drinks/shakes alone - I drink about one a day. More than that may overload your system with too much sugar.

If I were you I'd try foods on the BRAT diet (banana, rice, applesauce, toast/bread). Peanut butter, hard cheeses, potatoes, and pasta are usually good, too. These are all gentle foods that will bulk up and slow down in your digestive tract. Eggs and chicken usually are pretty safe forms of protein, and well-cooked carrots are highly tolerable as a veggie. I would also recommend Metamucil (psyllium husk powder) to bulk things up and absorb some of those digestive fluids that burn so much on the way out.

To answer your question, I go between 5-10 times per day depending on what I've eaten. I can reduce this a bit more if I take bowel-slowers like Imodium or Lomotil. I avoid raw vegetables, nuts/seeds, whole grains, chocolate, and caffeine, which all still cause additional bathroom trips for me. I go most frequently in the evenings, at night, and early morning. Fortunately, the slowest part of the day is during my work hours.

Surprisingly enough, my j-pouch really likes junk food: mac n cheese, burgers and fries (minus the sesame seeds and veggies), grilled cheese sandwiches, etc. and I don't think I'm the only one! I would try expanding your diet a bit and see what happens - just avoid some of those trigger foods.

Let me know if you have any other questions! :-)
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I'm glad to hear you are doing so well 4 months out! It gives me more hope! I'm one month out, and just starting to feel somewhat normal again. I'm going about 10 times a day though, and have horrible butt burn (mainly itchiness after I go to the bathroom). Did you have this issue? If so, any suggestions on how to get rid of it? I've tried most over the counter products for diaper rash and hemorrhoids.

Again, I'm glad to hear you are doing so well and enjoying life again!!!
L
Actually, I still experience that issue. I have not found any creams or ointments to have much of an effect on preventing butt burn or itching, though I do use an ointment to help soothe and protect the irritated skin once it's already raw. What I HAVE found to help butt burn is taking Metamucil (psyllium husk powder) once or twice a day. Somehow the psyllium husk tends to soak up the digestive juices that cause the irritation in the first place. It helps a lot with that issue; just make sure not to take it with any other meds, as it can interfere with absorption. Other than that I'm just waiting for that skin to thicken up and become less sensitive as it gets used to the new "system".
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Liz-

No I have not had any issues with leakage at all. The only time I had a tiny bit of a leak was when I had major diarrhea from coming off of a solid month of antibiotics. Other than that, zilch.

Occasionally if I haven't emptied out enough before exercise, the jostling and gravity of jogging will make me feel like I need to go, but I can always hold it as long as I need (though it can get pretty uncomfortable at times).

Sex has not been a problem at all. Everything functions normally. Sometimes I will feel the need to go several minutes after I finish having sex, but never during. (I assume it's because the j-pouch is right next to the vagina and gets jostled a bit during intercourse.)

Some factors that may affect the leakage issue (or lack thereof): I had a top-notch surgeon who left less than 1cm of rectal cuff in tact and used the double-stapling technique, which is much more effective at retaining continence and is the most commonly used anastamosis technique nowadays. I also had UC for seventeen years prior, so I had a lot of practice at differentiating between what is trying to come out... whether it is stool or just gas. I believe that most people who experience leaks think they are in fact passing gas only to end up with a surprise!

Yes, my life is definitely better than it was with an iliostomy. With an ileo, I felt somewhat limited on clothing choices, always had to have supplies with me, constantly had to upkeep the appliances perfectly, stressed about leakage or ulceration around the stoma, and could not exercise because the vigorous movement jostled the bag to the point of becoming a constant irritation and caused more ulceration. Now I don't have to worry about any of that.

The feeling of the need to go more frequently than I'm used to can be annoying, but I can live with that, and I'm guessing it will become less of an issue over time as I get used to the new sensations and as my pouch matures. The most frustrating part of having a j-pouch is waking up once or twice a night to go... but that was an issue when I had an ileo, too. I'm hoping that if I adjust my eating and sleeping schedule enough, and as my pouch matures, eventually that issue will die out as well.

If you have any other questions, feel free to let me know! :-)
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