Hi everyone. I had surgery for a J Pouche three months ago and I have been experiencing slight constipation which is driving me crazy. Particularly during the night time when approximately every hour or so I have to get out of bed and go to the toilet for a tiny bit of faeces to come out and go back to bed only to repeat the same procedure about half a dozen times in the one night. It is exhausting to say the least. My Doctor told me to take lomotil which not only stops my j pouche from working but also gives me urinary bladder retention. Has anyone experienced any of these problems with their Pouche. I would be interested to hear from you.
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I'd hesitate to take lomotil with your symptoms. If things are hard to pass because they're too thick, lomotil is likely not helping.
Have be you been checked for a stricture? Narrowing at the outlet could be the root cause of your issues. Your surgeon can tell with a rectal exam. If the issue, dilation can help. My stricture hit me like a ton of bricks, and I could barely pass a thing when it did.
But if not that, and things are too thick, you can try a few things. Some swear by grape juice. Some apple juice. Prune juice for others. For me, magnesium sulfate tabs loosen things up as needed (1/2 to 2 tabs, based on symptoms).
Have be you been checked for a stricture? Narrowing at the outlet could be the root cause of your issues. Your surgeon can tell with a rectal exam. If the issue, dilation can help. My stricture hit me like a ton of bricks, and I could barely pass a thing when it did.
But if not that, and things are too thick, you can try a few things. Some swear by grape juice. Some apple juice. Prune juice for others. For me, magnesium sulfate tabs loosen things up as needed (1/2 to 2 tabs, based on symptoms).
is it possible you feel the need to empty because of gas? I sometimes get quite gassy at night whilst sleeping and if I go to the toilet not much stool comes out. I thought this was constipation but I think its just that there isn't actually much stool in the pouch.
however I've learnt to release the gas when lying down on my right side in bed. massively reduces the number of toilet trips and I sleep through the night more often now
I do sometimes sit on the toilet for 10 mins or so because after the first empty, it can take a few minutes for stool to move down again to the pouch outlet. usually its 3 or 4 waves of emptying in one sitting and then im good for a few hours
Hi everyone. Thank you for those suggestions. I really enjoy reading notes from this chat group because it helps me to feel that I am not alone with this j pouche issue. I went to the surgeon yesterday and he suggested that it was not a stricture and that he thot I should try metamucil. Actually before I saw him I did try prune juice Rachel and it seemed to help a lot. I'll also remember apple and grape juice in the future. Also Shainy you might be right when you mentioned gas. As soon as I lay down I continually feel the need to get up and go to the bathroom and yes this is preceded by a gassy feeling. It's a learning process and as time goes by you tend to learn a lot about yourself and your new bowel function. Also thanks for the info on j pouches function. I don't normally sit on the toilet for ten minutes in the middle of the night because being the middle of winter it is too cold here. But maybe that is what I'll have to do to get a good nights sleep. Thank you for your replies. All the best with your pouche journeys as well.
Originally Posted by Francesca:
Hi everyone. Thank you for those suggestions. I really enjoy reading notes from this chat group because it helps me to feel that I am not alone with this j pouche issue. I went to the surgeon yesterday and he suggested that it was not a stricture and that he thot I should try metamucil. Actually before I saw him I did try prune juice Rachel and it seemed to help a lot. I'll also remember apple and grape juice in the future. Also Shainy you might be right when you mentioned gas. As soon as I lay down I continually feel the need to get up and go to the bathroom and yes this is preceded by a gassy feeling. It's a learning process and as time goes by you tend to learn a lot about yourself and your new bowel function. Also thanks for the info on j pouches function. I don't normally sit on the toilet for ten minutes in the middle of the night because being the middle of winter it is too cold here. But maybe that is what I'll have to do to get a good nights sleep. Thank you for your replies. All the best with your pouche journeys as well.
If gas is an issue, Metamucil can make it worse. Others site Citrucel as less gas producing. Just a thought. I don't use either.
Thanks for that suggestion. I've never been able to take Metamucil with success before surgery so I'm personally not sure how good it would be now. I'll give Citrucel a go. Not familiar with the brand name so will check it out. Thanks for your help. Am currently juggling bladder and bowel issues. I have found that if I get on top of the bowel issues then the bladder problems improve. It's an interesting life if you don't weaken!
I forgot to add that I also suffered from urinary retention after the jpouch creation surgery and also at takedown.
the retention after jpouch surgery was worse and I had to self catheterize for several weeks after. neither my surgeon or the urologist knew what was causing this.
after a while it just cleared up. My feeling is that it was due to the pelvic floor seizing up and I found it was easier to pass urine when I relaxed the pelvic area. I think the trauma of pelvic surgery caused this and it just went away when things calmed down.
perhaps look into exercises to relax the pelvic floor area?
That is exactly my experience Shainy. In fact the urinary retention made the whole J Pouche experience very difficult. I could only pass urine if I laid down for a period of time, maybe to ease the pressure on the pelvic floor.?? I also have been self catheterising. I don't like that experience but I do it less now that the j pouche is settling in. Actually I am currently on 50mg macrodantin antibiotics from the urologist Because of recurrent bladder infections. The urologist and surgeon are not sure why I have this problem too and believe it is because I must have had a urology problem pre surgery ( which is not true). But now I drink a lot of water and squeeze lemon juice into the water bottle. Which I drink a lot of. I also take a cranberry supplement as well as 1000g of vitamin C each day. I also make sure I keep my pouche cleared out As best I can. This Is helping my bladder too. Hopefully I'm on the right track. It's good to know that there is someone else with a similar experience. Thank you for your comment it really is encouraging. Cheers.
Something else to think about since you said it was at night. I always have to sleep on my back at night, the minute I move on my side it feels like I have to go to the bathroom and if I do go it's just a little bit and gas. For some reason it puts my pouch in a position that makes me feel like I have to go so I just stay on my back and I can sometimes sleep 9 hours without a trip to the bathroom.
For me, not really. I asked my surgeon about it one time and he was surprised to hear it but thought about it and came up with a diagram on why it would feel that way, of course I didn't really understand it, just I guess for a few people laying on your side puts your pouch in a position that makes you feel like you need to go. If I go to bathroom in the middle of nigh I might be able to lay on my side for a couple of hours before the feeling hits but I mostly stay on my back.