7 months out and nights are still rough

That is a lot to be going between 7 and 11 pm. The only thing I can suggest is maybe try and cut out the dessert after dinner as a test. I know sugar increases my frequency. Also, are you taking Imodium or such like it?

Fq, sorry to hear about the high frequency at 7 months out. I am approaching 9 months by early february so I'm pretty close to your position.

I definitely agree with mgmt10. The ice cream at night is probably a bad decision! I used to eat the same thing a few months after the takedown as I wanted to put more weight back on. But the ice cream tends to go right through you and has absolutely no bulk to it to slow things down. Also I'd try to stay away from french fries or other fatty fried foods as they can further exacerbate bathroom trips. The oatmeal is generally always a good choice in the morning to bulk things up. Yiu can also do bagels with cream cheese or other toppings as they are good carbs and bulk. The fish and chicken is also a good choice for mild lucnhes or for dinner. I had some good salmon and chicken last night for dinner! Just be sure to include some cooked veggies with the food to promote the movement of the food but also the bulk. Be careful not to over do it with the veggies though as it can cause some backup or discomfort. Good veggies that work for me are sweet peas, asparagus tips, steamed green beans, very well cooked carrots, and cauliflower. A good mix of one type of vegetable or a small portion of two is a great compliment to the chicken, fish, and rice.

As for the night bowel movements, part of the trick is to find good thick foods that will suck up excess water or fluids at night when you're trying to sleep and your muscles are very relaxed. I usually try to stick with foods that are sticky or thick to swallow at night like peanut butter or some nutella. Also you can try Metamucil wafers throughout the day (if you havent already) and before sleep to add bulk. The wafers are tremendously helpful with adding form to our stools which automatically slows things down.

I have trouble at times as well though so don't feel too discouraged or down about going 10-12 times a day still. Sometimes I have days that are exactly like yours with 2-4 night time bathroom trips and a good amount during the day. On average though I'd say I'm generally okay with it and go about 6-8 times per day including night time trips. Good luck with it and try to keep positive my friend.

Are you taking anti-spasmodics before meals? In my first year after takedown I had a problem with a spasmodic pouch which increased my frequency of BMs especially after meals. Levsin, donnatal, or bentyl can be taken 30-45 minutes before meals to address these issues.

fq-

Do you know whether you're lactose intolerant? Taking Lactaid capsules might help reduce frequency. Do you have urgency or pain when you have to go?

Hi FQ,

I have had my j pouch for about 18 months and I am able to sleep thought the night without a trip to the loo. I don't find different types of food or how late I eat has an impact.

The lactose issue is worth investigating. Maybe trial a few lactose free days and see if there is any improvement.

At 7 months I would think you are far enough along to use Imodium or similar prior to bedtime.

Hopefully you can get yourself a decent night's sleep soon. I remember that time of my life and it was not fun

Everybody is very different on what foods work, chicken does not agree with me unless it is combined with something that will bind it up like mac and cheese. I actually found that just plain cheeseburgers (no lettuce, tomato, etc.) work real good as an evening meal.

The lists of foods that are recommended for people with a JPouch both good and bad are a good starting point but try other things and see what happens.

And yes I hate saying it but ice cream in the evening is probably not the best idea.

I would try changing your diet. Some of the foods that give me greater frequency are foods that you are eating; oatmeal, french fries, yogurt, and cake and ice cream. You might try eliminating all sugar at evening meals, substituting a salad for fries, and cream of wheat for oatmeal.

Sue

thanks everyone! wow, such helpful responses

Sometimes I DO have urgency and pain / difficulty evacuating.

But...that does not happen with every BM. Which leads me to think it is diet-related and NOT pouchitis or pouch issue??? If urgency/discomfort happens only 25-50% of BM's, does it mean it is diet, instead of pouchitis?

Crazy how some foods and minor tweaks in diet can drastically alter pouch function.

I am hoping it is not a pouch issue and ONLY diet-related.

I have tried anti-diarrhea/anti-spasm drugs, but I prefer to control my bowels with diet or with hope that one day my pouch will be "Magically and Superbly Adapted Without Drugs" Wishful thinking?

Since I am eating some of these things which cause higher frequency, I have only a couple choices it seems??:
(1) Don't eat them (e.g. give up cake and ice cream )
(2) Take anti-spasm
(3) Deal with extra bathroom visits and extra gas/pain from some of these foods

suebear - Interesting you mention salad. I haven't eaten any salad since takedown....can you believe it?? I heard it actually increases frequency. Plus I was nervous about raw veggies. I guess I will try a little bit.

I find that with diet I can limit my frequency to 4-6X per day. However, I don't like eating that way so I choose to have a higher frequency and eat the way I prefer to eat.

Yes, you can limit the foods that give you greater frequency, or deal with the consequences. Your pouch will continue to mature so months or a year from now you may find you can tolerate cake and ice cream better.

I eat what I want, knowing what the outcome will be, sometimes I monitor myself better than other times. Sometimes I take a couple anti spasmodics, sometimes a bowel slower, but most of the time I just deal with the increased frequency.

You can choose how you want to manage this. There is no right or wrong.

Sue

I am I'm five months out and I also hive night issues. After my night time meal I do go a little more often and then I set an alarm for 2:30 am, without I would soil myself every time. I still wear a adult pad to bed as about 1/3 of the time I get significant spotting that would ruin my underwear, night pants, and possibly sheets.

A few things I have found that help as I try to get through this: no liquids past 8-9pm. Even if I'm thirsty I try to avoid until the morning. Trey to eat dinner by 6, which is difficult when my wife gets off of work at 5 or 5:30.

My doctor has recommended taking a single anti-diareal, when I get up at 2:30 which I do from time to time when the stool is loose to avoid soiling a pad before I get up at 6:30.
Most of the whole pouch thing has been good. but, I have been very displeased with my progress at night. I have yet to sleep an entire night since the surgery. And studies on people who fail to sleep through a night are not positive.

don't eat past 7. take 2 lomotil or immodum before bedtime. East a banana and apple sauce. don't drink while eating. You might need bigger guns to slow you down. Talk to your doc about something to slow frequency.