This is not indicative of future problems.  My output was that high in the beginning; I only noticed improvement after six weeks.  Is she taking imodium or lomotil?  Has she tried fiber?  She can take the antibiotics, it will reduce her frequency and give her some relief but once the dose ends the frequency will return.  If this isn't pouchitis then I would try diet, bowel slowers, and fiber. 

Sue

Some people say the first 10-14 days are worse then their UC flares.  But they do say that it goes away with some time.

Everyone is different, I did not have the problem of frequency but it was a little painful at first.  I'm 8 months out and things are good now. 

Even if it is pouchitis (and I agree with the other posters), most cases just need a couple of weeks of antibiotics.

If there are no signs of pouchitis on scope, I am curious as to why an antibiotic has been prescribed.  I always try to leave antibiotics as a last resort line of defense especially when pouchitis has not been confirmed, since I don't tolerate the side effects very well, and because there are other options that may be more practical than taking antibiotics indefinitely.  So I would try other routes first, such as imodium or lomotil, as well as dietary stool thickeners such as peanut butter, rice, greek yogurt, and bananas.

As others have mentioned, high and even very high output is common in the first few weeks post op. Night time leakage is also common in the early takedown period. It's unpleasant but not unexpected. And just because she has it now does not mean your daughter will continue to have these issues for the long term.

Personally, the first thing I would do is try imodium. My surgeon has said that we can take up to 8 imodium a day indefinitely. However, I wouldn't go the full 8 all at once as you may in fact cause the opposite problem, that being constipation. Stool that is very thick can be hard to pass. Therefore, a suggestion would be to start with 2 tablets at breakfast and 2 before bed.   If there isn't noticeable improvement with 4, then your daughter could add another 1-2 tablets with lunch and dinner, increasing up to 8 tablets per day. The timing and dosage can be adjusted up and down as needed. Imodium tablets can be easily broken in half too if necessary, which gives you even more dosing options. Your daughter may have to experiment with the dosing schedule a bit to tweak it to what works for her.

Thanks all!  

She is already on the max Imodium, 8 per day. I didn´t feel it worked when she had her ostomy bag either, she always had very high and liquidy output but the surgeon thought it would be better after takedown.  I picked up the Flagyl script but am going to hold off because I too feel it´s a last resort thing especially since the scope was negative for pouchitis and she has no other symptoms besides frequency. She is pretty much pain free most of the time and shes staying hydrated.

And knock on wood, she has only had 2 BM´s since 9am, a 5 hour period. I´m sure she got rid of everything last night going 20 times!  I am going to continue the VSL as well. Also trying Fibercon which someone here recommended as Metamucil gives her gas. Will keep her diet very bland as well.

Thanks for all the feedback, it´s been very helpful. Patience is not a virtue of mine but I will try to be!

Best of health to all of you.

Mary Beth,

Hopefully this is a sign that things are looking up! I also had very watery output with my loop ileo no matter what I did, and I was also worried that I would have the same experience with the pouch, but it's mostly been fine. In fact, these days my stool can actually be TOO thick at times and I have to occasionally resort to prune juice to help get things moving.  Just food for thought!  In general, though, frequency starts to go down after 6-8 weeks post surgery, though in my own experience I started really noticing  improvements at about the 3 month mark.  It's a long an gradual process as your body adapts and your learn what routine best works for you, though I understand it's hard to be patient with these things.

As for the flagyl, it's good that you filled the prescription anyway, just to have it as a last resort. And you don't have to throw it out if she doesn't end up using it. Even though I very rarely take antibiotics anymore, I still have my own "stash" on hand and I always take some with me when I travel. As long as you store the flagyl in a cool dark place, it should be good for several years. (PS - it should not be refrigerated).

All the best to you.

The output of the Loop ileo doesn't give much of a clue on what to expect the output of the j-pouch to be after the take-down.  I'm a good example of that, I only need to empty my pouch 3-5 times a day but when I had my loop ileo they didn't want to let me leave the hospital because my output was so high.  They were even considering doing my reversal before releasing me (after only 2 weeks), they tried loperimide, lomotil, tincture of opium and Metamucil but nothing worked except for time for my intestine to heal and adapt.