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Hi. I'm hoping someone here could help lead me toward a solution for something that might help to "bind" my output. I am *not* looking to harden it (quite the opposite), and I don't know if "bulking" is the right term either. I've read in many places that things like psyllium, Benefiber, etc, can help bind, but my experiences in the past with fiber have been extremely uncomfortable.

The issue is that I'm completely at my wit's end with how I feel anywhere from 3-12 hours following dinner (the only real significant eating I do all day, for various reasons). I take epsom salts to help empty my J-pouch, and they've been a life-saver, but emptying after that initial go-around is (especially lately) always extremely difficult for me. Not sure how to explain without being a bit too graphic, but basically, every little thing I've eaten seems to want to exit on its own, and each one is a misery (I've had fistulas, strictures, etc). It's always been my understanding that J-pouchers have to deal with watery output, and rarely anything resembling constipation, but constipation has basically been my life for the past 5 years.

The good news is that balsalazide seems to have been helping quite a bit in relieving the pain/pressure I've long suffered from "down there." Unfortunately, I still have the difficulty in emptying to contend with, and even my latest GI doctor--who is far beyond all the rest I've seen--just tells me to "try a little Miralax," which doesn't even begin to make a dent in my problem. He contemplated that maybe my small intestine *really* took over for my missing colon. That's nice--it's still terrible.

So, in short: what are some things I might try (preferably in pill/capsule form, honestly) that are well-known to bind things together (and softening is a huge bonus)? Thanks!
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Can you try stool softeners? Have they found anything mechanically wrong with your pouch. Strictures can cause your issues. If you have had them have they tried anything to correct them? Anal stenosis can also create some of the issues you are describing as I suffer from this also. It sounds like you need a good GI work up if you have not already had this done.
Thanks so much for your replies thus far. I apologize for not responding sooner--this issue keeps me busier than I'd like to be.

Strictures have been found in the past and dilated, with no difference in feeling nor BMs afterward. Stool softeners like generic Colace have been tried with little difference, but I'm experimenting with them (along with Lactulose) again. Epsom salts are the only thing that empty me effectively, but then my leakage is far worse throughout the night, and quite annoying. Amazingly, even with lots of epsom salts, I still sometimes feel like there's something "down there" that won't come out.

I should have mentioned in my post that I cannot afford any tests whatsoever, hospital or no. I can only afford generic medications and the occasional office visit. I'd love to get mass tests done to find out what's up, but that could easily push me into a bankruptcy situation right now, because of where I live (you might be able to guess).

The cholestyramine sounds interesting. I'll do some research.
Since you've had strictures in the past, it might be worthwhile to see your GI if you haven't seen him recently, to rule out a recurrence (though I understand that your situation may make it harder to see a doctor). You don't tolerate fiber products so no point recommending those. Smiler

Sometimes pouch patients are prescribed tap-water enemas for fecal stasis, which can help clear out the pouch and and reduce straining. This is something you can do at home - buy a fleet enema kit, empty out the fleet and then refill the enema with tap water. You may want to do this after dinner and/or before bed. Probitics may be helpful as well, if you are not already taken them.

Best of luck!
Milk of Magnesium, have you tried that? I was warned because, I take magnesium supplements that they might contribute to loose BM's, as the surgeon used the example of Milk of Magnesium. Or you might want to take magnesium supplements, I would think they would cost more and be harder to gage the dosage. I don't know if this is a good idea for the long run....

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