Pepto Bismol will put the kabosh on the diarrhea. BTW I doubt the fiber is causing the diarrhea. More likely is untreated pouchitis. When you use bowel slowers like Imodium you can get blocked up and this causes excessive bacteria, pouchitis, and ultimately diarrhea.

I am pretty sure I have sibo, that’s why I suspect the diarrhea is coming from the fiber. Might be a reaction

@Fredz posted:

I am 10 months post takedown and when I take imodium and psyllium husk my stools are bulky, but then I wake up the middle of the night with watery diarrhea. I wondering if the psyllium husk is causing my diarrhea. I have read that it is used to bulk stool, but Dr Bo Shen mentioned somewhere that it’s a double edged sword and might cause diarrhea. Thoughts? Imma quit the fiber and give it a few days. I also take betaine hcl w pepsin for digestion.

The fiber reacts differently in people. Over the years I took fiber on & off with good effect, but the last time I took it, it actually made things worse, diarrhea, stomach pains. The only way I figured out it was the fiber causing. I stopped eating, started introducing 1 thing at a time. I no longer take psyllium.
Your doctor is right!

I also wouldn't blame the psyllium husk for diarrhea. Especially if you don't drink too much together with it. In my experience nightly watery diarrhea is caused by dysbiosis, the small intestine tries to get rid of bacteria by flushing water into the bowel and washing them out (which is the normal diarrhea reaction). Since I'm on antibiotics I don't have that kind of problem.

@SteveG posted:

I also wouldn't blame the psyllium husk for diarrhea. Especially if you don't drink too much together with it. In my experience nightly watery diarrhea is caused by dysbiosis, the small intestine tries to get rid of bacteria by flushing water into the bowel and washing them out (which is the normal diarrhea reaction). Since I'm on antibiotics I don't have that kind of problem.

Interesting. How do I treat dysbiosis? Antibiotics?

When I had a severe dysbiosis in the past antibiotics were the best option. For a mild dysbiosis you may also try reducing sugar intake or add probiotics.

I have chronic pouchitis / ileitis and for me antibiotics are the only med so far that helps to reduce inflammation significantly. So you might have success with other measures that involve less (potential) side effects.

@Fredz You have gotten some good advice here. I just wanted to tell you my experience.  I get watery diarrhea in the middle of the night because that's when my bowels wake up and get active and I'll be bulky one night and watery the next depending on what I ate. If I ate some veggies or something spicy then I'll def have watery output.

My evenings generally go like this……no eating past 6 pm. I drink water in the evening. I usually have maybe 3-4 trips to the washroom in the evening, 11 pm a tablespoon of phyillium POWDER, 2 Imodium then to bed. Works most nights. I also use Phyllium powder and Imodium if I’m exercising or a busy day. My pouch was checked internally 6 years ago. Only a small rash was found on 1 side. It’s my belief the phyillium powder neutralizes the acids in my bowel when the stool reaches my pouch. My pouch is 36 years old and is working!

@Jpouchlolly posted:

My evenings generally go like this……no eating past 6 pm. I drink water in the evening. I usually have maybe 3-4 trips to the washroom in the evening, 11 pm a tablespoon of phyillium POWDER, 2 Imodium then to bed. Works most nights. I also use Phyllium powder and Imodium if I’m exercising or a busy day. My pouch was checked internally 6 years ago. Only a small rash was found on 1 side. It’s my belief the phyillium powder neutralizes the acids in my bowel when the stool reaches my pouch. My pouch is 36 years old and is working!

That’s great to hear, nice to meet another long time poucher!

Wow 41 years!,  amazing!,,, are you high functioning?

Where was your surgery done?