Lomotil and Tincture of Opium are popular options around here. Most doctors in the US would prescribe those before trying codeine (in fact with the painkiller abuse issue we have I think many would never prescribe codeine for dehydration).

I'd also choose Lomotil (diphenoxylate/atropine) over codeine. Your post doesn't say whether you're drinking plenty of water or not, so I hesitate to recommend the obvious (i.e. drink more water). I would suggest you eliminate any diuretics from your diet (e.g. coffee, tea, cola, alcohol).

Thanks for the responses so far.

Yes I am following the diet recommended. So I am drinking 2 litres per day, with no caffeine or alcohol. With a low fiber diet.

Is it clear to you where all that water is going? Do you have frequent, watery stools?

I think the low-fiber could go either way. Metamucil or Citrucel will carry some water out with it, but by thickening the stool it can give your body more time to absorb the water it needs.

I too have the same problem so sympathise.

Have you tried using liquid loperamide or opening the loperamide capsules as this sometimes helps absorption. Do you take them half an hour or so before you eat? I am on codeine 60mg x 3 as well as loperamide and have to say after a while the codeine didn't effect me. If it is still a problem maybe try just taking it at night and using loperamide in the day.

The other thing I have done are regular urinary sodium and potassium checks - just pee in a pot which is so much easier than a blood test! If the sodium is low in your pee then you maybe dehydrated even if your bloods are normal and I would suggest finding a gastro doctor who has expertise in short bowel syndrome (where you don't have enough small bowel left to absorb things properly) or functional short bowel syndrome (where technically you have enough small bowel but it doesn't work effectively). I was diagnosed with this and have had various treatments including manipulation of oral fluids and electrolyte intake but have ended up on home IV fluids, which is at least better than having to go into hospital.

High EP - I take codeine (60mg up to 4 times a day) and loperamide and don't find the codeine has any adverse effects on me (though my husband has to go to bed when he takes them - his knockout drops!!)
I have never heard of checking for dehydration via a urine sample (that sounds so easy) it has always been bloodwork - and if you are dehydrated - its like getting blood out of a stone! I did once ask about home IV fluids and was told it was not done in my area - may I ask which health authority you are in (or the area you come from)

Hi - I have sent you a pm.

@Ep - I am probably being blind but I cant see how to access my PMs, any tips?

Hi briggsie

I too struggled with hydration issues and it ended up being my nephrologist who helped me work through them. I was drinking the recommended two litres a day, but after tracking my ins and outs (stool and pee) with 24 hour collections and blood work numerous times it turns out that in order for me to be properly hydrated I need to drink at least 3.5 litres a day - and I aim to drink more like 4 litres because that is when I feel the best.

2 litres a day may not be enough for you, so try going to 3 litres a day for a week and see how you feel. I should mention - water is what counts, I don't drink anything sugary or with caffeine.

If you have a PM you have not read, there will be a new tab at the top of the forums list indicating the same. You just click on that. Otherwise, you can go to your private messages by clicking on "J-Pouch Community," then "Personal Zone," then "Private Messaging."

Jan