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I've had sporadic episodes of sometimes quite bad bloating for the past year or so (final j-pouch op during 2015). Had one of these just over a month ago, but it went away after a few hours (with the help of mint tea). However, I developed a fever which was 'on and off' for a few days following, which resulted in a late-night visit to the hospital. I was admitted with suspected Covid, which proved negative. Then, they thought it may be UC (I haven't had any UC since my j-pouch). Cut a long story short, I had a rectosigmoidoscopy, which showed no sign of UC and a biopsy was taken from the small bowel (prior to this, I had around 3 x-rays and a CT scan showing some slight dilation of the small intestine). The gastro consultant suspected chronic intestinal pseudo obstruction CIPO. Spent a not very pleasant week in hospital..... At a recent follow-up appt, I asked whether the fever could have been caused by an infection in the intestines, due to food sitting there too long. Yep, he agreed that was a strong possibility. My use of loperamide was questioned. To be honest, I've been taking 4mg most nights, just as a 'precaution'. It seems my 'over-use' likely caused the intestines  motility to reduce too much, causing the food to sit around too long,etc. (Causing the bloating).

  Since leaving the hospital on 30th July, I've dumped the loperamide and I've only had one bloating episode (more than likely due to eating 2 meals too close together) Moral of the story: if you've got any unresolved/unexplained bloating issues please consider whether your use of loperamide may be the culprit!  Of course, this drug can be a very useful part of some individuals' 'toolkits', but I just thought I'd let you have my experience.

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Yep, a very rational and well stated take on chronic use of bowel slowers. This is true for all of them, not just loperamide.

The main take away is to assess your need for these things. Once a year I stop taking my loperamide to see if still makes a difference. I still take 4 a day after more than 25 years. No obstructions here.

Jan

Thank you GS and Jan;

I am several months removed from from my final surgery and a pattern has emerged for me. Unless I take loperamide 2 to 3 times per day, my pouch won’t work well. After several good days i wind up with frequency, diarrhea, severe butt burn, nighttime leaking and horrible spasms. When this happens it then takes several levsin and several days for a return to some normalcy.  

i really don’t like having to live on meds, but so far this is my path. I do not like having to deal with a constipated feeling, and the slow emptying of the pouch. So yes for me, I can definitely overdo the bowel slowers,  but it still beats the other extreme.  

Jan, when you do your once a year experiment what do you experience?



eric

Last edited by New577

When I do my loperamide “drug holiday” I always get increased frequency and more watery stool. I do not concern myself with being on or off meds. I have been taking meds for 50 years since I was diagnosed with UC. Plus now I have diabetes, cardiac arrhythmias, fatty liver disease, enteropathic arthritis, mild kidney disease, and other things. So, I am happy there are treatments available.

Bottom line, I have been taking loperamide consistently since 1995 without ill effect. But, I do not try to achieve solid stool with it, only manageable frequency and avoid dehydration.

Jan.

At one point,  after surgeries 2013. I took 4 to 6 a day.   I never have constipation.  I take 2x a day now.  I went to 1 & it didn't work for me.  A few x's in the past I have such nausea & bloating I have to make myself vomit until I had nothing left to feel better.  I wonder if it was CIPO?  This just occurred 1 mo ago.  Dr thinks a small bowel obstruction.  What do u think?  I'm back to 2 lopermide a day.  I lost 10lbs in this past yr.  Awaiting a cat scan.

https://www.j-pouch.org/topic/...0#678557053644833450

Omgoodness, after my takedown I also was high producer of continual water loose BMs -  yes, at night sleeping would release watery fluids, so I used pads, but would not be too proud to wear adult leak underwear 🤗. I also slept with a throw blanket under me.  
NOW, I soon realized the fiber I used for UC would absorb that fluid !!!  Awesome results for my issues 🙌.  Good luck.

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