Early days post-surgery questions

Jen, was your three-weeks-ago surgery just a takedown of a loop ileostomy, or was it something larger? How many stages was your J-pouch surgery performed with?

Scott F.,

My three-weeks-ago surgery was a one stage J-pouch creation and takedown of the ileostomy I’d had for nearly a year from when my colon perforated August 2019.

Hi Jen Marie,

Were you not instructed to stick with a low fiber diet for 6-8 weeks after the surgery?

I had three step IPAA. The first one  was subtotal colectomy, the second was j-pouch creation, and the third was reversal. After the first two steps, I was instructed to stay on low fiber diet for around 6-8 weeks. 

The post-op diet was much shorter after the final step for me, but it was merely a ileostomy reversal surgery. The j-pouch had 3 full months to heal, so my bowels were not manipulated at all during my last surgery. 

Since you have a newly built j-pouch, I assume your bowels would also need a post-op diet - the standard 6-8 weeks of low fiber diet. You can google it, it is a very standard post-op diet.

I suggest that you to stick to a low fiber diet until your bleeding stops, and maybe until 6 weeks after post-op to be safe. I would recommend against spicy foods while having bleeding as well.

Finally, you should contact your surgical team ASAP about the bleeding. I don’t mean to scare you, but you might be having a post-surgical complication.

Hi, Jen Marie.  For the first 6 months or more after your takedown, and when you start using your J pouch, stay away from corn and anything else that is insoluble fiber. You can google "insoluble fiber foods" so you will know what to stay away from. It's not forever; just for a few months until your J pouch learns what to do and how to help you live. Corn, whether it is corn on the cob at this time of year when it is abundant and sweet, or canned corn or corn pudding. No corn. It does not dissolve and that is why your pouch is giving you frequency and watery diarrhea. Mushrooms can cause the same problems. Carrots, bell peppers, salads,  cucumbers with skin on, all can cause explosive results for a new J pouch.

Google "J pouch post-op diet."  Also choose "soluble food" to see what to eat for now.  Always peel and cook all your vegetables very well. I know it's like eating mushy food when all you want are crunchy raw salads or spicy Indian food that contain lentils, wonderful exotic spices, and grains and vegetables. But if you want a healthy J pouch for your whole life, then you need to start off properly. For now, no spicy or fiber-based Indian food, and that includes any other ethnic food that has raw, spicy, seeds, grains, raw vegetables, or nuts (you can have nut butters such as almond butter, peanut butter which are good for the pouch and helps form good semi formed stools).  Don't force your J pouch to work overtime by indulging. It will only cause so much frequency and loose stools, or constipation, and then comes bloody stools because your J pouch is irritated inside, and you might end up with fissures. Fissures in the anal area will feel like you are pushing out razor blades that were set on fire.  You want to have your J pouch for a long time so take care of it early on.  Why are you taking fiber supplements? Did someone tell you to?  I agree with Elif: check with your surgeon about blood in your stools, tell them what your diet has been. It's probably almost time for your first post-op appointment anyway?

I was on a low residue diet after each of my surgeries for at least a month and slowly introduced different foods especially after takedown.  

I agree with everyone else so far. I also was on low fiber for about a month to six weeks. Maybe back off on spicy stuff for a sort while. It's always good to start to slowly add in new foods, then you will know how your new pouch will react to them. Good luck, remember to be kind to yourself and know with time things do get better.

Aimee