Hello, J. Simpson. I was the same with any tomato-based sauces. Now I am okay with them. Tomatoes are acidic and this might cause the burn you are feeling. If you make your own sauce, you can cut some acid by adding baking soda or a bit of sugar. Google it for amounts. I still can't eat citrus fruits for this same reason. Burns on the way out and causes soreness for days. But I keep trying every few weeks to re-introduce citrus fruit to see if my pouch will tolerate. 

Hi, Winterberry!

Oh yeah! Completely forgot the fact the sauce would be acidic. That would explain the burn. How long did it take for you to start comfortably passing stools after eating such meals? Are you okay with slightly spicy meals?

Hi, JordySimo. I think I started eating tomato-based sauces in August or September (reversal was in April) and there were no problems. Before that I couldn't tolerate it. I just kept trying once in a while, and either my pouch matured or it got used to the tomatoes! I can eat mild curries and mild spicy foods, but very mild only. I make a slow cooker casserole of white bean and turkey with chopped tomatoes, zucchini, onions and I am good. In the beginning I feared beans!  Now my pouch behaves like a healthy colon: solid and formed BMs. The black beans you ate have skin (all beans have skin) that is insoluable so that might cause you some issues, until your pouch matures. I go slowly and carefully, trial and error. What you can't eat this week, try again later. I try to have three meals and two snacks in between so I don't feel so starved that I eat anything I can find -- not good. You are lucky to tolerate chocolate! 

Thanks a lot for the info, Winterberry! That's relieving to know that it's just a case of waiting. I hope my pouch becomes as well-functioned as yours. That's the thing, I don't know if I can tolerate chocolate... I keep eating it and don't know if that could be causing a bit of burning.... What time do you stop eating each day can I ask?

Also, slightly off this topic of soreness, but do you automatically tense up and strain when passing stools?

Cheers

Hi, JordySimo.

If your pouch is affected by sugar or carbs, remember that chocolate is both these things!  There are rumours that dark chocolate is somehow better for you. I don't know if that is true. The sugar in your chocolate might be brewing some pouchitis issues for you. Read the label to see what it contains. I usually stop eating around 6:30 or 7pm. If I am hungry later I toast a slice of sourdough bread (the starter for sourdough bread is probiotic -- in any case it's the only type of bread that doesn't irritate my pouch) with almond butter from Costco. We go through so much almond butter here and the Costco brand (Kirkland) is really good. Big jar, $9 or so. It doesn't contain added sugar or salt or preservatives; it is 100% roasted almonds. No, I don't tense up or strain. Straining can lead to fissures, which are very bad and extremely painful. If you automatically strain or tense, train yourself to relax. Focus. Your pouch and muscles know what to do, or they will as time goes on. Metamucil helps some pouchers, and a diet that includes well cooked, soft vegetables such as sliced roasted zucchini (peeled!!) or sweet potatoes. 

JordySimo,

the tensing up should get better as the inflammation decreases; however, I have problems with tensing up (even if I do my best not to strain) and I end up getting fissures. What I have found to help is to slightly decrease the amount I eat (so I don't have to go to the bathroom as often) and my pouch specialist prescribes 500 mg cipro twice a day for 10 days. Also, and probably most importantly, is the nifedipine/lidocaine compounded ointment. Some people on here say they use diltiazem but same idea. You apply a Lea size amount to the anal opening four time per day (or after each bowel movement) and it relaxes the sphincter muscle (calcium inhibitors prevent the muscles from contracting). 

If it gets unbearable tensing to the point of wear you feel pain down your leg Or throughout your entire buttocks (like what happened to me) then there are further options. A few moths ago my doc injected my anal sphincter in two small locations with Botox to prevent it from tensing too much. This comes with its own small problems but they are nowhere as bad as the pain from the straining/tensing. Let me know if you have more questions Bc I am still struggling with his issue and have been explorIng a lot of different things with it. I've found that I can't lift weights on consecutive days Bc it'll bring the symptoms back, etc. 

Hi J Moons,

I've actually been able to tense up and strain a bit with no problems, but I'm just worried if the straining will obviously affect the pouch or cause urination problems. I don't think I've had a fissure... I just keep having soreness from the foods I'm eating. How do you know when you have a fissure?

My surgeon told me that I shouldn't strain for more than 30 seconds, but today I have been doing well not to tense up and strain. I've been relaxing but it seems to just drip out when I relax, whereas if I push it a bit, I manage to get more stool out. I have been passing wind alright when relaxing and a little bit of stool passes when I do pass wind. But if I just relax on the toilet, it'll probably take quite a long time before all my stool is passed.

Though, I have to bear in mind, I'm only 2 months post-op... So stools may become easier to pass when relaxed in the near future once everything has adjusted. Is that a possibility? Once my consistency and urgency settles... maybe things will improve in regards to passing stool.

I notice around Christmas that my butt does get irritated a bit and I am almost positive it is the sugars -- candy, cookies, desserts that I just ... can't ... keep ... away from!  Hopefully, all these things will be out of the house soon.

One idea to cut down acidity in tomato sauce (which I love) is to grind up carrots.  Yep.  Carrots.  I learned in from my sister-in-law who always has great tasting sauce!  Give it a shot! 

We likely all have different ideas about when gentle pushing crosses the line into straining. Pushing a bit against a relaxed sphincter is necessary to empty a J-pouch, in my experience. Pushing hard to extrude formed stools through a contracted sphincter will cause trouble. Just try to be gentle with yourself, with soft stools, gentle pressure, and a relaxed sphincter.

Yeah, I don't sit on the toilet and literally strain really hard with a lot of pressure. My stomach tenses up when the stool is being passed and that causes a little few seconds of strain whilst it's being passed. If I stayed relaxed, it wouldn't empty the pouch completely. I'm glad you mentioned it is necessary from your experience as I thought it was literally a case of relaxing and everything just slid out at once.