I'm not vegan, but I do follow a mainly vegetarian diet (I still occasionally eat fish, but otherwise no meat).  Although we do have a couple of other vegans on this forum who do very well, in the early stages post takedown, you may have to make some concessions with what you eat, meaning that unfortunately, you may not be able to follow a strictly vegan diet (if even only temporarily). Given your digestion issues as you describe them, you would probably have to start back with a very bland diet and give your system some time to adjust, and then gradually add back the foods you were accustomed to eating before, a few at a time, and see how you do with them.  Obviously low iron is a problem for you; I struggled with it for years after my colon was removed. It's really only been in the last 2.5 or so years that my iron levels have been stable, so I understand how you feel. If you are not taking an iron supplement, you should be. If your levels are very low, infusions may be a suggestion. Also, considering that you have followed a vegan diet and also have IBD, you should get your B12 levels tested as this may be an issue for you as well. Your overall protein levels should also be evaluated. 

At this point, you should be looking to blander, bulking foods such as rice, oatmeal, toast, bananas, and peanut butter as good options for calming your digestion and easing up on the "butt burn." The bleeding you are experiencing could be cuffitis or pouchitis, but it may also be plain old run of the mill hemorrhoids or irritation, and a blander diet should go a way toward easing that.  If you can make an allowance for Greek or Icelandic yogurt, this is a good choice as well.  As far as eating vegetables at this stage, blended soups are something I have always been able to manage. Juicing is good option too, but make sure you watch the sugar content of the fruit, as excess sugar is a culprit for poor pouch function for many of us. 

Hopefully in the future you will be able to get back to eating the foods you are used to, but in the meantime, you may have to make some modifications to your diet, at least until your system adjusts and normalizes. 

My doctor is always getting on me for the vegan diet because he says it may be part of the reason my pouch has grown so large. The undigested plant matter increases gas and just the bulk in general may have encourage it to increase in size to accommodate the amount of indigestible fiber. That being said, most of the time I'm fine. Sometimes, like when things are stressful and the pouch isn't working up to par, I stay away from uncooked fruits and veggies. I did, for a while, make delicious food and blend it in a bullet blender. Looked like baby food but tasted the same as what everyone else was eating. You will find your way. Also, when you hear people talk about using marshmallows to slow things down, remember there are vegan marshmallows out there, Dandies brand.

Hi Clark,

I wasn't vegan but was a strict vegetarian up to my surgery (15 years ago). I found it very difficult to follow this diet post surgery and ended up becoming an omnivore again as I just couldn't get enough nutrition from plant-based foods given I couldn't eat half of them. Soy was great in the form of tofu, because it was easily digestible, but anything with a lot of fiber (quinoa, couscous, bran,  many veggies/fruits,, etc.) just made me feel Ill all the time. In hindsight I'm not sure if it was a lack of protein needed for healing, lack of vitamins, or moreso because it aggregated my pouch and caused watery stools to the point that I was constantly dehydrated and food moving through so fast that I couldn't absorb a lot of it. On top of that i became lactose intolerant post surgery (although vegans would eat this anyway I guess), and all the dietary restrictions just made it really hard to have a balanced diet and control pouch output. I felt a world better when I ate less fibre and more bulky foods (rice, potato, pasta, bananas, applesauce, only cooked veggies, and cheese and for me,, animal proteins, but respect this may not be an option for you). If you can find a plant-based protein powder in combination with cooked fruits and veggies, maybe that might help to slow things down while still getting a lot of nutrition. And if u take supplements, investigate liquid forms--my dr. And I discovered just 5 years ago that pill form multivitamins don't get absorbed for me--who knew?!

Good luck to you.

Hi Clark,

Not sure if you're still checking this post, as it has been 8 months since you posted it, but just in case, I wanted to reach out and support you in your vegan lifestyle and ethic.  I had my colectomy and J-pouch construction at age 17 in 2000.  I am now 34.  I was vegetarian for 8 years before becoming full vegan about a year ago.

You're still early in your healing journey, and your digestive tract is still trying to figure things out.  However, with the invention of the juicer and the blender and nutritional yeast, there is no reason to give up your very important ethical choice of following a vegan diet.  

I would recommend making smoothies, juices, and pureed soups for a while so you can get your fruits and veggies.  Nut butters and hummus are also great and easily digestible.  Drink nut and soy milks.  I love a tofu scramble with turmeric.  You can puree frozen bananas for an "ice cream" treat.  Depending on how things go, slowly work your way up.  I eat all kinds of veggies, fruit, nuts, tofu, and grains without a problem.  Your colon has been removed, so it's never going to be like it was, but there is no reason for you to stop eating cruelty-free food.  

It's definitely worth asking your doctor for probiotics (I just started VSL #3DS recently and it has worked wonders) as well as a digestive enzyme.  

I hope this helps and I hope you are feeling better and doing well with the pouch!  Please feel free to reach out.  I would love to connect with fellow vegan J-pouchers.

Take Care,

Drummer Girl

No way!  My diet would be so limited and I'd be spending even more time than I care for in the bathroom if I ate nothing but vegetables.   Not that I ate any meat today to begin with unless you want to include a little bacon bits in brown rice. 

Super keen on more info from the vegetarian and vegan members.  How many bm's do you have /day?  My family is vegetarian, and when I eat what i've cooked for them, ie vegan chili, or masala or anything, the lack of meat speeds everything up for me and I'm up 5x+ per night without meat.    

Hi Wendy! As a vegan I do not have to get up during the night. It might be a function of how new your pouch is. I think, and I may be wrong, that most things go pretty fast through our pouch systems. You might try some Dandies vegan marshmallows to slow things. Or the bulking fiber products that lots of people talk about in other threads. And definitely stop eating several hours before you go to bed. Also, maybe eat things with less spice. The only thing I know for sure goes through my system super fast is raw vegetables. So avoid those in the evening. It's a little bit harder in general to eat a plant based diet because the world isn't set up that way - yet. But there are more and more vegan items coming on the market to help you along. Maybe throw in some of those meat substitute crumbles or eat a couple of veggie hot dogs. Though more processed than whole foods, they are pretty friendly to the pouch in terms of making things go as normal as possible. It loos like Drummer Girl (above) might have some good advice, so you can message her as well. Best of luck!

A lot of people want to snap fingers and see instant results from the surgery, but do not fully appreciate it takes a very long time for the J Pouch to adjust/adapt. Veganism is doable with a Pouch, but I do not believe it is realistic or a good idea for the first year after takedown.  My worst blockages were due to raw veggies, however I now eat a large salad every day for lunch and have no problems whatsoever.  What I eat for lunch now I would not have in my first year after takedown.  Just write down "it's a long road", take a deep breath and relax and you will be okay.

I find it fairly amazing what you can get at some high end vegan restaurants in my area, one example being GZen in Branford, CT:

http://www.g-zen.com/gzen-menu-dinner.php

Their cheeses/dairy all derive from Cashew Milk.  I believe it's technically Vegan. The pasta is made from organic beet, carrot and daikon noodles.  I just bought some fresh daikon this past weekend and I put it in salads.  But their veggie pastas are the bomb.  Their spanakopita is also very good, although I don't think my buddy's organically Greek mother would agree.

Thanks everybody...my takedown was 2005, so def not a newbie, just trying to make healthier/sustainable eating choices that my jpouch can handle.

Wendy,

At the 13 year mark, whatever your pouch can handle is what it can handle. This will vary with the individual. I can handle pretty much anything, and I eat a salad every day for lunch. I am not a Vegan per se, but occasionally have Vegan days. I find that eating a lot of vegetables actually assists in promoting regularity. Antibiotics tend to thicken up my stool, and a lot of fiber IMHO helps clean me out a little better. 

Its really important to chew foods well. 28 chews minimum and then swallow. This is especially important eating raw veggies and salads.

How much meat I eat is usually partly a function of who I am dating at the moment. I have had Vegan/Vegetarian girlfriends and deferred to their culinary choices. At the moment I am seeing someone who isn’t vegetarian and her favorite things to eat seem to be chicken wings and macaroni and cheese with pulled pork. Which is called Mac and Jack.

I think the only think that blocks me from being a full time vegetarian is that I occasionally crave the taste of meat. But there is no difference in my Pouch function except for a very few foods that trigger diarrhea like red wine and eating certain unskinnd veggies like eggplant. Eggplant Parm is my go-to dish at any Italian restaurant as a general rule, unless they aren’t skinning the eggplants. I just made mental notes of things I can’t do but it’s a really short list fortunately.

Really a bigger concern is striving for the elimination of carbs and sugars, which naturally comes along with a vegetarian diet in my opinion. So it’s not the veggies that is a plus as much as the lack of processed carbs and sugars. Those have to go out of the diet, they are just poison for a Pouch.

Good luck finding what works for you.