You should have pouchitis ruled out, and even if it is, you may need a course of antibiotics for bacterial overgrowth.

Jan

I don't know what an S pouch is ... I have a J pouch and I was going about 15 times a day. Went to my surgeon and she told me the high frequency made my butt RAW. She wouldn't even touch it. I couldn't sit and I was miserable. I was applying a prescription cream containing steroids and lidocaine. Also inserting a suppository containing a steroid. She told me to STOP BOTH IMMEDIATELY because the steroid was exacerbating the problem. I was also taking Imodium. 

She prescribed Lidocaine Ointment 30G. Whenever I go to the bathroom, switched me to 2 Lomotil every 4 hours as needed along with 3 MARSHMALLOWS... It worked. I still go a lot but the pain is mostly gone. I only go about 4 times a day but it's quick. It's during the night I'm up every 3-4 hours but it is improving. Hang in there and I hope you feel better. I also stay away from fiber �� which I miss tremendously but such is life. Good Luck and I hope this helps!!!!

My jpouch is one month old today and I'm easily going 8-10 times a day please someone  tell me this gets better!!! ... I have more to live for then a bathroom ... 

It gets better! Trial and error with meds!!!��

Janiep posted:

It gets better! Trial and error with meds!!!��

Thank you JanieP I really believe it will I'm just having some really bad days I pray and have faith that it will get better 

I hope everything gets better, I still have the ileo- for 11 years....it was meant to be temporary. However, I have an end ileo, not a loop, I still have 25% of colon left just floating in pelvis. With that said, I have had numerous surgeons, say wait for the J-Pouch until I have kids( male, complication can be not to have kids for J pouch- although a minimal % chance ), others say why wait? My ileo, I empty maybe 5 times a day at worst, 3-4 normal. Idk if that is bc I had the Ileo for so long and my intestine learned to over compensate for the lack of colon. However, 10x times a day would be a huge amount for me as well bc when I had UC @ 19, then an ileo at 19....The worst day with UC was 12-13 times a day. I averaged 6-10 with UC, but the blood I lost was crazy. So I can understand why 10x or more a day would be a large amount, if you only had that with UC. Idk what you were like with UC or what ailed you. However, for those that had it 20X times a day with UC, might find 10x as a benefit compared to 20x. That is double the reduction. However, if your UC was like mine 6-10, then 10x would be deemed a Not great quality after going through all the surgery. I think the surgery and outcomes needs to be updated, and based on patient and what they were like before. If you look @ Cleveland clinic studies, they only have a 9% fail rate( 91% Success ) within 10 years of J pouch. However, out of a survey only 77% reported having a good quality of life. Being in my eyes Quality of Life is important, that 23% admitted to having a poor QOL. Being that the failure rate does not address quality of life, and the stats are statistically scewed for failure rate, not quality of life. Then on top of the 23%, you wonder how many checked the box good, but were taking a lot of meds and didn't check poor. That being said, I can break down the diet I eat with an ileo, and emptying average 3-4x a day( including nights ). I will add a + mark for muscle building.

Breakfast:

Whole wheat toast- leaving the burnt on toast. Adding jelly or non transfat butter.

Oatmeal.

Bananas.

Cereal. 

Lunch

Whole wheat Bread

Greek Yogurt.....however yoplait and trix yogurt( for good bacteria ).

Turkey off the bone( the closer you get to the bone, less preservatives )

All Natural chips( that means no Fritos or your normal potato chips )

Peanut butter( all nautral ) and jelly ) + muscle building

Egg white protein( I know, not the most glorified protein, but it is like Casien protein in that it Digested Slowly ) + Muscle Building

String Cheese( all natural ).- Good protein source.

Little debbie( cheat )

Dinner: ( The mass Meal )

2x Fillets of fish or 2x pieces of chicken. For fish, Non atlantic fish, as is atlantic fish can be farmed and can contain chemicals ). Chicken, cooked, being no fast food...I rarely ever eat fast food or at a restaurant- screwed up a few dates in my dating life...but O well.( add olive oil for good fats and adding calories ) + Muscle.

Potatoes 3x or rice 2.5 servings( carb up ). The body needs carbs, it's not all about protein!+ Muscle...Potatoes I put some all natural cheese, or non trans fat butter while bulking.....if cutting, no )

Salad- A thought nemesis, however, one small bowl full and some ranch dressing favored me over Italian dressing( I am Italian ). The ugly fats in dressing still help in weight gain. + Muscle* When I say salad I mean lettuce, no onions etc...

Veggies: Peas, Green beans.....Never was a carrot eater.

Late Snack: Almonds crushed( you can buy them like this, or crush them yourself ) with yogurt. Pretzels( hugeley under estimated and frowned in BodyBuilding, but my stool 75% of time is thick.....

Protein: Egg white protein or whey+ Muscle Building. Whey protein is quickly absorbed, therefore is in and out....but I would get 32grams-40 grams of protein in one drink, with low fats, and not much carbs ).....Cutting, I would eat protein whey bars....remember the quick absorbed and out I told you about. 

Alternative snacks: All natural crackers w peanut butter, -Apples with peanut butter, -my own created protein shake( 1 banana, 4 ice cubes, 1 lactose free ensure, egg white protein( 22g of protein ), ice cream( just one cup ), berries( small amounts )....Good shake. If trouble gaining weight + Muscle Olive oil. Pretzels( sometimes I would eat half a bag )+ Muscle, My own tortilla....( 8 0z of diced chicken, non wheat natural tortilla bread, all natural cheese....and that was it )....This had about 9 grams of protein from non wheat tortilla bread, another 20-28 grams of protein from chicken, another 4-5 grams of protein from cheese ). I know I did a lot of alternative snacks....but those are my primal ones. 

Really thinking Muscle and weight: Getting protein, fats, and carbs is always a consideration. So sometimes I added , even when out on dates---I would take a protein drink with me containing 20g or more of protein. I would put it in my car, out at the club in my car...I would excuse myself to go to my car and drink it. 

The concept of calories: Calories are just simply energy. That is it. So how many calories one burns vs their intake will be a factor in determining weight. Calories in access of sugar will turn fat, calories excess of unhealthy carbs will turn fat..Alternatively, calories from Healthy carbs- burn off quick, but protect from catabolism....the opposite of anabolism( growth). In this thinking, think Pregnisone( it is an anti-inflammatory, but is catabolic to the body...which people lose muscle or gain fat, or report balloon face ). Vs anabolic where people grow muscle, lean tissue etc.....Healthy fats( omega , Olive oil, etc ) will protect against catabolism and burn off fast...hence keeping you healthy vs the fat gaining fat. 

So if your absorbing a low rate, healthy carbs, healthy fats should not be frowned upon, just my take. 

What I drink( real life ): Propel, Vitamin water, G2....all have sugars that are not healthy..however, they do offer favorable Vitamins and anti-oxidants. Also I think it helps with absorbing bc the body is forced to recognize the Vitamins and absorb better than just water....and the opposite most namely any type of Pop. Pop or soda, depends on where you come from lol,either way contains a much higher amount of unhealthy carbs, fats, and sugars than Propel, Vitamin Water, and G2. So in comparing ounce per ounce, that is what I seen. 

Vitamins: Skip the pills. Get them via fluid/liquid. They absorb better( hence taking my statement of Vitamin Water and Propel ). However, a good multi liquid vitamin is a good key.

When I was sick and averaged beyond emptying my bag that 3-4/5 times a day, on my meals I just laid out. Simply I went to a Brat type diet

Bananas

Rice

Applesauce( to me a thickener )

Toast

But I had a Braty diet and added:

Yogurt- non greek. 

Alochol: Beer gives me fits, and I said "Real Life." Well, being maybe my age bracket through this age 19-30, alcohol and social events hit. Beer was a no go. I found, and by the way most bodybuilders find, clear alcohol is better. So vodkas. Famous Bodybuilders who are natural, note that Vodkas they would drink as opposed to whiskey or dark liquors made them have less hangovers AKA they could train a day after!....I myself found this a myth and a truth. Most vodkas kept me out of restrooms...Certain whiskeys....well....enough said. Beer with all it's ingredients....Always( maybe besides 1 ) gave me problems. 

Other drinks that effected me wrong: I mean Vitamin drinks.

- Cranberry

- Grape

- THOSE TWO. * Anti-Muscle.

However, what I neglected to write was Pasta. I mean it's not like all my dinners were 2x fillets of fish, with olive oil and garlic, 3x potatoes, and/or rice was like that all the time. Oddly enough, I found gnocci to be more favorable than that of pizza or regular spaghetti. Ok me being Italian, How could I possibly not note this. Gnocci is simple to make, and I always pour a light souce on most spaghetti. Gnocci kills a lot of birds with one stone....it does have an ok amount of protein, good enough carbs, and fats. 

Deviled eggs? Never heard of them, but dislike eggs? Boom! Simply I found and still find this delicious and provides a good amount of all categories in protein, fats, and carbs....just don't over indulge!

Yogurt and Pro-Biotics.....My take? Vastly first, I would be remissed  if I again didn't state I have an ileostomy. Conversely I do not experience " Pouchitis ".....However, I do not have a pouch that collects things and absorbs. I also cannot address the psycho- social....or psychology of having an ileo. I mean most have a J-pouch to not have one!!!! Anxiety can actually stimulate the bowel to 3-5x faster than not having any anxiety. If you have an ileo, this game is eventually understood. Now with that said, lets look at Yogurt.....

Yogurt....You grateful 5 grams of protein( 10-15 grams for Greek ) tasteful but controversial food. My take......Yes, it is great for pro-biotics...but too much can in my opinion**** cause to much regularity. Just like anything, too much of something, can be bad. I don't eat this with every meal and for a reason. However, putting good bacteria( PRO ) in the body is great! So I stick with 1 to 2 , 2 being max pure day. When I was cutting, I leaned on Greek yogurt more, as Greek has virtually no fat. During my cutting, I eat about 55g-65 g of fat max per day. Remember Calories in and out? If you don't, read the beginning. 

Simply things are broken down to this MACRO Nutrients: Carbs, Fat, and protein. These are the vital things that makes up grow, or lose. Not enough? You lose weight. Too much? You gain weight. Of course ileostomy patients, and pouchers do have to consider absorption rate given this. However, the model is still the same...You eat more than the body absorbs, needs....You gain weight....You eat less, or intake less than absorb.....You are more apt to lose weight. Somewhere in between this you can maintain. The TYPE of MACRO Nutrients can play a factor in maintaining+gaining good quality weight vs losing or maintaining good quality weight. So it is important in my opinion, to know what TYPE of MACRO nutrients( again carbs, fats, and proteins ) you are getting from calories. In a Nutshell,  the total Calories you intake vs absorption and what you expend will determine weight. However, the type of MACROS you get will play a factor in the quality of what you might lose or gain. 

However, there is a thing called Micro Nutrients AKA Vitamins. These really help with the function of the body. If you have all your MACROS in place, but your Micro( Vitamins if you will ) are off....well....talk to a person who gets all the protein, fats, and carbs, but are Iron deficient....and you might get a person who is pale, has trouble keeping valuable muscle, etc. Vitamin D( D3 ) levels can lead to less hormone production, and thus leaving valuable testosterone in Men without full maximal muscle and or sleep. So Micro nutrients, in my humble opinion, most neglected are a factor in this Puzzle. 

Okay, so it's calories in and out! Macros and Micros! Geeze and we thought the cosmos were hard to study. Also these are vital to ATP production in the cell, another source for energy. Without all the psycho babble and pseudo science.....Take Creatine, found in Meat.....Some people lack. So...companies make a supplement, it's called....Ready????....Drum roll.....Creatine! However, if your diet and absorption rate are ok, then the need for this " Supplement ", that is found naturally in food...btw...that is why Creatine has not been illegal, it is naturally occurring in food. See that FDA level that says," This has not been evaluated by the FDA yatta yatta can I get another yatta....over run sentence of disclaimer. They can hide behind this label, simply bc.....IT IS NATURALLY OCCURRING In food and the body. So get enough food and absorption, you get enough creatine. The interesting thing about creatine, is that it does in fact increase ATP( more energy ). So it's calories in and out, Macros determine quality if enough calories, and Micros help keep us healthy and function properly. Now what about that gnat called absorption?

********So with an ileo, I found Marshmallows( wow I spelled that correct ) and applesauce, rice, and Bananas.....help with thickening. I will leave the pretzel and almond debate on the table as I cannot attest to the pouch. I would say, almonds would be off the table, more than on, just like corn.....no not the band Korn( who sang ," Freak on a Leash "- although sometimes with an ileo I feel that way ). Yes I have occurred a partial blockage or two....sike...make that like 4-5 times! I would say, marshmallows( I still spell that right? Cmon where is my third grade teacher ), bananas, applesauce, and rice....Never Contributed to those blockages. I would say, that when I had a partial blockage( or a male giving child birth j/k...but after I had a few, I don't blame a pregnant women for taking an epidural ..respect to women...respect ) that drinking hot cocoa or warm tea, helped. Speaking of help, I hope that this helps. Although, I know I deviated away from topic. I just figured I would help with the cosmos of Nutrition from an ileostomy and my perspective. 

Feel better. 

- Crazy1

Have sure been there - many times - but my experience was that it did not last and with determination I could get it working better - always have gone about 8 times a day now...right now I am sick with something ...going a lot more and sort of freaking out - but have had pouch 30 years and most of years were good ones...hang in there....it does take trial and error and "the patience of the ocean." 

early days. very early days post takedown. people talk about up to a year for adjustment period. crazy went crazy and gave you a very detailed menu to follow. you can also reference the dietary guidelines found here under the information tab. we each respond fractionally differently to food but some hard facts are that INSOLUBLE fiber will make you go, however, soluble fiber, especially for those missing the bodys natural dessicator, will help form stools. for decades, i used soluble fiber in the form of Metamucil and yes its marketed as a laxative but the soluble fiber worked to soak up the liquids and add form to my stools. the less liquid your stools the less you will likely have to go. you can try an experiment put a tbsp. of Metamucil in a glass of water mix and watch what happens over the next hour, or less. voila!

start a food journal to note how YOU respond to foods. this is a long and arduous process and to be candid I never did but it is your best learning tool.

some patients tweak output with meds like immodium and lomotil, having had zero success with immodium when i had a bad colon, i was never sold on the idea and my personal experience with lomotil is that while it oddly can effectively hit  the pause button, that ultimately my total # of bm's don't change on the day. but maybe that's just me and my quirky plumbing.

over time as your pouch adjusts, and you adjust, your # of bms will most likely slow down. talk to your GI and surgeon about strategies. as well as trying some of the ideas that you will find on this site.

Janiep posted:

I don't know what an S pouch is ... I have a J pouch and I was going about 15 times a day. Went to my surgeon and she told me the high frequency made my butt RAW. She wouldn't even touch it. I couldn't sit and I was miserable. I was applying a prescription cream containing steroids and lidocaine. Also inserting a suppository containing a steroid. She told me to STOP BOTH IMMEDIATELY because the steroid was exacerbating the problem. I was also taking Imodium. 

She prescribed Lidocaine Ointment 30G. Whenever I go to the bathroom, switched me to 2 Lomotil every 4 hours as needed along with 3 MARSHMALLOWS... It worked. I still go a lot but the pain is mostly gone. I only go about 4 times a day but it's quick. It's during the night I'm up every 3-4 hours but it is improving. Hang in there and I hope you feel better. I also stay away from fiber �� which I miss tremendously but such is life. Good Luck and I hope this helps!!!!

Try butt wipes with witch hazel. You can get them at Walmart. I've had a pouch for 15yrs and nothing helps more than them. Use a wipe after every bm.

Great advice - yep - Walmart butt wipes - always - but had not thought of witch hazel - will get some and add it to my toilet seat top!