Hi: Has anyone experienced increased gas, and pain in lower back, but without watery stools? I definitely don't have the normal pouchitis (watery stools, fatigue, fever, etc.), but I have something. I normally don't get this bloated. I'm thinking it is due to food, because it is worse when I eat. If I just drink coffee then I'm fine, but anything else makes it worse. I really have not changed my diet recently. I'm just wondering if I need a round of antibiotics to kill the bacteria, or load up on probiotics. I've found that the antibiotics help with the gas, but I hate to go on Flagyl and Levaquin when I don't have pouchitis. The only other change in my life has been the use of Rogaine foam on my hair. I can't see how that would cause any issues, but if my diet has stayed the same, and I didn't have gas before, then something is causing it. Sugar seems to make it worse. I've never had any of these issues before (15 years), unless it was with pouchitis. Thanks.
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This does sound like bacterial overgrowth. You can try probiotics, but don't be shy about going on a short course of antibiotics to nip this in the bud. When you had a colon, there was a one-way valve between the colon and the ileum to prevent "backwash" of the colon contents. The j-pouch does not have this, so it is not uncommon for bacteria to migrate out of the pouch and populate areas where it can cause trouble. Gas is a side effect of bacterial action on undigested carbs. So high levels of sugar or more fiber than you can pass through quick enough, will lead to the gas side effect. This is why we often advise against slowing the gut too much in efforts to achieve more solid stools.
Plus, just because you did not have this problem before is no reason you cannot have it now. It becomes more likely the longer you have your pouch.
Bottom line, leave bacterial overgrowth untreated long enough, you'll wind up with pouchitis. When I develop those symptoms and they become persistent, I treat with a course of Flagyl, then stay on probiotics in the hope of maintaining balance. Even with the probiotics, I still have periodic relapse.
Jan 
Originally Posted by Jan Dollar:
When you had a colon, there was a one-way valve between the colon and the ileum to prevent "backwash" of the conon contents. The j-pouch does not have this, so it is not uncommon for bacteria to migrate out of the pouch and populate areas where it can cause trouble
Jan is right about this. I in fact have a swath of inflammation in my neoterminal ileum due to SIBO. If I were to eat a large amount of ice cream I would have massive gas. The main thing one needs to do to control SIBO is watch the diet. Large amounts of sugar and carbs are bad. Eat a protein rich diet and cut out processed foods. Use common sense and things will improve. You can't eat like you did with your colon when you have these issues.
So I don't mean to hijack this thread but I believe I'm having similar issues as the OP. I' had my takedown about 5.5 months ago and since have gone through two rounds of cipro/flagyl. My symptoms aren't really pouchitis at least I don't have a fever, blood, or even very watery stool. However I am have gas (somewhat explosive), increased frequency and discomfort in my pouch. My surgeon hasn't done a scope yet but we are scheduling one now to rule things out. However based on this posting and the responses so far the bacteria thing makes a lot of sense as my symptoms seem to "build" over time...it's so odd and difficult to explain.
After seeing the advice about diet and eliminating carbs/sugar, would you be able to provide a link to such a diet please? I'm very undisciplined with food (I've always had he mantra if I excerise a lot I can eat what I want and while apperance wise that may work for me, clearly it didn't help with my UC and now my pouch). So I need something structured that almost spells it out for me if possible. So I'm really interested in seeing if a diet plan like this will help. I mean I eat something that doesn't agree with me and it seems to trigger a backslide that I can't really come completely back from unless I "baseline" with antibiotics.
Any and all help would be greatly appreciated.
After seeing the advice about diet and eliminating carbs/sugar, would you be able to provide a link to such a diet please? I'm very undisciplined with food (I've always had he mantra if I excerise a lot I can eat what I want and while apperance wise that may work for me, clearly it didn't help with my UC and now my pouch). So I need something structured that almost spells it out for me if possible. So I'm really interested in seeing if a diet plan like this will help. I mean I eat something that doesn't agree with me and it seems to trigger a backslide that I can't really come completely back from unless I "baseline" with antibiotics.
Any and all help would be greatly appreciated.
Rabbit. I can't help with the diet. For me I just try to avoid too many veggies. And the more food you eat, the more you go. You're body is still adjusting. It took me a couple of years to stabilize. I recommend trying probiotics. They really make a difference with the gas. I have my favorite I get at GNC. I'm on Flagyl for a week to see if it helps. It doesn't seem to hurt to clean out the system here and there.
Yea I take VSL #3. I think most of what I'm going through is still healing and adjusting. Last night I ate salmon and rice and feel great (I did take a lomotil as well) but certain foods or something is bothering me. I think I just need to continue to stay fairly bland. I'll keep experimenting, thanks for the input!
Try reading about the FODMAP diet. By going through an elimination, I found some of my worst triggers, and I just avoid those foods. Luckily I am not bothered by onions or garlic, but those are big offenders. I *am* bothered terribly by things like apples and peaches, and the "bean" category (like for many people; the galactans). It's worth just reading about. There are many internet sites about it, and a book written by the folks who created it.
Here's a link to books. I know it says IBS, but it is restriction of offending sugars to help with gas, which in our case is what we sometimes need.
http://www.amazon.com/s/?ie=UT...f=pd_sl_7t2ef9eqwp_b
http://www.amazon.com/s/?ie=UT...f=pd_sl_7t2ef9eqwp_b
Wow, perfect! That's exactly what I'm looking for. Thanks for the book suggestion, ordering it now. I had a blooming onion on Saturday which started this backslide. I think I got it under control with rice and salmon last night but that sounds great. Thanks again.
Hope it helps you! To do it "right" you have to eliminate all offenders, then introduce slowly. Good luck!