9 weeks post op

I had one question I forget to put in my previous post. Does anyone have experience taking tramadol for pain? I have been on it for over a year and still take it daily. I'm wondering if it's doing more damage than good. 

Thank you again for your time. 

Mike, I think most folks are able to reduce their BMs more than that by 9 weeks, though it's a long road for others. Are you trying to hold it in ("stretch the pouch"), or just going when you feel like it's time? Is it urgent (are you running or walking to the bathroom)? Are you doing kegels? Experimenting with your diet (one experiment is worth 10 pieces of advice)? Trying soluble fiber (e.g. psyllium, Benefiber, Citrucel)? Using Lomotil or Imodium?

I'm not a big fan of Tramadol or other opioids for chronic pain, except as a last resort, but other folks here have used various ones of these successfully for years. You don't say what you're using it for. Other opioids might have the beneficial side effect of slowing your gut down (more than Tramadol).

Scott, thanks for your reply. For the most part I felt everything was mostly normal until about three days ago. My BM's increased substantially. The last two nights have been sleepless and spent in the bathroom. At first I was able to hold it without a problem. Today alone I have gone to the bathroom 20 times, I have been running to get there and have not made it in time a couple times.  I haven't had much to eat either in the last 24 hours, trying to give everything a break. My stool's are very watery, which concerns me. I told my surgeon this via email this morning, he told me to increase my imodium to two tablets every six hours. As far as fiber goes he suggested to take Benefiber twice daily, I did it for a couple of days and felt like something was off so I stopped and just stuck with the imodium. Maybe I should get back on it. I have taken the tramadol for discomfort and pain, along with the bowel issues I have two bulging disks. Even though it's not the strongest drug it's seems to have helped me over the last year. I've tried others but they don't seem to help. In the past tramadol has helped slowing down the bowel movements, this time around I wonder if it's messing with me. The weird thing is though I've been on two meds for the last year consistently, tramadol and celexa. I don't think they have anything to do with it because I've been on them so long. I have tried kegel exercises when I feel an urge. I try to calm down by breathing and work the muscles. Today though just no control at all. 

Thank you again for your reply, sorry for any grammar errors, I typed this in a hurry. 

With a sudden, dramatic change such as this, I am surprised your surgeon isn't being more proactive. It could easily be a swift moving virus, in which case, it should run its course in a matter of days. Imodium could make it worse by keeping it in your system longer, but it seems that you are well past it making much difference. Don't hesitate to go to the ER for IV fluids if you get too weak or become dizzy, since you could dehydrate quickly.

If this persists, then you need to consider acute pouchitis or bacterial overgrowth. Antibiotics would set you straight within a day or so.

Jan

Thank you Jan for the reply. My situation kind of sucks because of my surgeon being in Boston while I just moved to Colorado. I'm waiting for my new GI to contact me for an appointment time. I was thinking about going to a primary doctor tomorrow to see if he or she can prescribe me an antibiotic. I'm going to see how tonight goes though and take action tomorrow. 

Sounds like a plan. Your primary may be hesitant to treat, but if you bring in an article about pouchitis showing him the symptoms, treatment, and likely diagnosis, he might prescribe based on symptoms. You could print up the article linked in the "sticky" post at the top of the pouchitis forum, or just print an abstract from PubMed.

Jan

I'd think the GI bug more likely than pouchitis, just because bugs are common and three days isn't long enough to tell them apart. If you do see a primary care doc you'll need to be patient, since he/she will probably never have heard of pouchitis.

I didn't find that Benefiber worked well for me. I've had better success with psyllium (Metamucil, Konsyl).

So I had a great night last night, I only had 2 BM's and both were with control. I agree with both you guys, I had some sort of bug or infection that passed through. It was rough, I'm happy that it seems to be over. Thank you very much for your help and suggestions guys. I'm realizing for this all to be better you really need to put the effort in. I guess I was hoping I would magically be normal again and not have to try.