Food questions - pooping hurts!

I have learned over the past 2.5 years with my jpouch that there sometimes is just no rhyme or reason to it. Honestly I pretty much gave up trying to figure it out. I can eat identically three days in a row and each day my j pouch function is different. I just try now to eat healthy meals and I don't deprive myself of treats if I want something. I do know that sugar tends to up my frequency. Today I have lots of gas. I have eaten the same things today as yesterday and yesterday I wasn't gassy. Who the heck knows! I haven't experienced pouchitis as of yet, so I can't answer that one.

First of all, what you are describing sounds like anal irritation, not pouchitis. While there may be that sort of discomfort with pouchitis, it does not come and go like that, and the symptoms have more to do with frequency, urgency, and a sensation of incomplete emptying.

Most all of the pain receptors down there are in the anal canal, so it does not take much irritation for pain and spasms to occur. Once that "butt burn" is there, just the slightest indiscretion in the diet will send you screaming from the toilet.

So, once you have this affliction (which is better prevented than treated), you go to your basic, boring diet without fruit, vegetables, dairy, nuts, whatever, that might set it off. Use barrier cream faithfully until things are under control, and bowel slowers too. You can try experimenting with probiotics too, but just remember they can take months for a full effect. Then gradually add foods, one at a time in small quantities, until you know they are tolerated. You will probably be putzing around this way for 6-12 months, so don't be discouraged.

If you are having rectal bleeding much of the time, along with what seems like pouchitis symptoms, it probably is cuffitis and you need treatment for it.

Jan

thanks!! yeah, it may be anal irritation instead of pouch irritation (can't always tell the difference??). But I really am confused and annoyed by the extreme pouch personalities. One day it's happy and quiet, the next day angry and needs attention. like mgmt10 said it varies so much, even if I eat the same thing.

Yesterday my pouch acted like a helium balloon...so much gas on every trip!!! Today, it is "calm". So I guess it's not pouchitis, and it's diet???

@ Jan - you said pouchitis is: "frequency, urgency, and a sensation of incomplete emptying."
I DO get that sometimes!!! I am 7 months out, and sometimes after a meal, I get an urgent need to poop. Sometimes, my frequency goes up to 15 times a day. Sometimes I don't feel empty and have to go back 30-60 minutes later. Sometimes I feel urgency, but it's just gas and it doesn't come out. But then other times I will be fine for 3-4 hours. Does that sound like pouchitis??? Or just reaction to foods?

My pouch confuses me !!!

Like I said, if it is pouchitis, it does not come and go. The urgency, frequency, etc. is all the time, every day, no matter what you eat. When I have pouchitis, no amount of Imodium helps. But, one dose of Flagyl and I'm back on track.

What you describe sounds like diet and adaptation, along with anal irritation. Could be some bacterial overgrowth, but that would be more consistent too.

Even 17+ years post-op, my output is not terribly predictable, mostly consistently inconsistent. So, time has given me the ability to just ignore it, because my frequency is reasonable, and I don't have butt burn. At least THAT is something to look forward to!

Jan

I am 6 years since takedown and do pretty well but I cut off food way before 8PM to stop BMs at night dusturbing sleep. We eat dinnner around 3PM and have snack, very light meal around 5 or 6 PM and at later mels I do not eat much fiber like veggies, or beans, cabbagte, etc.

I might be lucky. I'm posting this for the benefit of others who might stumble across this post that are considering a JPouch.

I eat up to the moment I go to bed. Sometimes I get up 1 or 2 times at night for a BM, but about 1/2 the time, I sleep right through until morning.

For me, having a J-Pouch is not much different from my old colon-rectum set up.

I tried cutting off eating early in the evening, and it actually made things worse. My gut just churned and cramped, and of course, I would lay in bed thinking about my next meal! Plus, more gas was generated, sending me to the bathroom repeatedly. I eat late lots of times, but try not to eat pizza just before bed. Many people say a small snack settles things for them.

Over the years I don't know if my pouch has adapted more, or I have adapted more. Either way, I have made peace with my gut, more or less. The biggest lesson learned was not to expect perfection!

Jan