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Hi, 

I have a J-Pouch since summer 2009 at the age of 17 years old, after 4 years of horrible UC without any success with pharmaceutics. 

the J-Pouch surgery saved my life and made me almost 100% "normal". I have about 5-6 bowel mouvements a day. 

I have a mostly plant based diet. A lot of the vegetables and fruit I eat seem to not be totally digested when I pass them. Especially with the smoothies I do every morning. This concerns me... I am absorbing the nutrients in them ? 

The smoothie consists of kale, apple, kiwi, banana, avocado, ginger, cucomber, frozen berries & orange juice. 

Most of the time I will drink this smoothie on an empty stomach and 1h30 after it already passes through...  

Are you experiencing the same thing ? 

I have a follow-up appointment with my surgeon at the end of August. 

Thank you! 

 

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Based on what you said above you are fine.  Digestion occurs in the small intestine.  When food enters the stomach, acid and enzymes start breaking it down.   10 to 15 minutes later the colic reflex kicks in which causes the digestive tract to contact and expand, so it works it's way down the digestive system.

 

 It passes through to the small intestine where the vitamins and minerals are absorbed.  It then drains into the colon whose sole job is to absorb water and act as a store so we don't have to dash to the loo every few minutes.

 

When I had ileostomy, eating to output was 45 mins to an hour.  So if your going 5 or 6 times a day, it would suggest food is spending enough time to be absorbed.  So time isn't and issue.

 

Of course it's not the time the food spends in the small intestine that's important, but rather it's efficiency. Enzyme deficiency or acid problems could interfere with absorbstion.  The best thing you can do to increase enzyme production is eating fresh greens, much like you are.  In short unless you have other issues or have had a significant portion of your shall intestine removed or some other reason to suspect malabsorption, your probally fine

 

What do you mean not absorbed? If blended your giving your making it easy on your body.  Veg is high residue food, meaning volume out is similar to volume in.

Hi Marc-Antoine

High-five to another teenage poucher! I got mine when I was 18, in 2004. I'm not vegetarian but eat very little red meat. Food generally passes through me within an 1h30 up to 3h (or longer sometimes if I can hold it in), and I definitely notice things like tomato skins, grapes/raisins, beetroot and onion are more obvious in the stool. But that would be true even if I had a colon, they would just be less obvious, so I don't worry too much. I think you'd know if you weren't getting enough nutrients from your food.

Good morning Marc-Antoine,

First off, kudos on the diet! That rocks... an inspiration for sure.

I am right there with you, about 90 minutes. I make it work to my benefit by knowing and plan accordingly before road trips and my hockey games. For many years i was concerned about the same thing, nutrient absorption. I have blood work done yearly and the only thing I am ever slightly low in is vit B (which I understand is mainly absorbed in the colon). I think you're totally good.

With that said I did have some issues with absorbing medication. At one time I was on various meds and it turned out I was not absorbing it to the fullest. After discussing this with my doc he advised me to avoid the time-released medications. He may have just pulled that out with no research but I tend to still follow this advice.

I think you're good... (insert choice of 'thumbs up' emoji here)

I am in same range as others have mentioned prior - 60 to 90 minutes. High residue foods may continue to appears to linger 6 to 12 hours.

I too question nutrient absorption 'efficiency'.  I am pretty skinny at 147 lbs and 6'0".  I could eat the entire buffet and would never gain weight - seems pretty unusual for a 52 yr old!  I guess this is a different topic though.

My total colectomy/j pouch (1 step) was done April 30, 2017 (almost 4 months)

My food goes right thru me still..  10-15 minutes after I start eating I have to go to the bathroom. For me, there is no holding it....  I try, but it just doesn't work...

i can see the food I just ate in the toilet....  hoping it starts to build up soon so I can last longer... 

DarrenKS posted:

I am in same range as others have mentioned prior - 60 to 90 minutes. High residue foods may continue to appears to linger 6 to 12 hours.

I too question nutrient absorption 'efficiency'.  I am pretty skinny at 147 lbs and 6'0".  I could eat the entire buffet and would never gain weight - seems pretty unusual for a 52 yr old!  I guess this is a different topic though.

I can eat and eat too... it's sorta frustrating because I have lost so much weight and am borderline "underweight" at the moment...  

My food goes right thru me still..  10-15 minutes after I start eating I have to go to the bathroom. For me, there is no holding it....  I try, but it just doesn't wоrk

Me too when eat after 20 30 minutes i go to bathroom and empty my pouch with my food .i go about 10 12 times per day.dunno if is normal but cannot hold much some time i hold 2 3 hours sometime after i eat i go to empty

You can be quite sure that after 10 or even 30 minutes it is not the food you've just been eating that you are passing. Many foods take even more time to pass the stomach.

When I had severe diarrhea it took about 1+ hour before I saw the first little pieces of the salad I had eaten before. But usually it takes several hours total passage time.

The other way round I can sleep well (often without going to the bathroom for 5...8 hours) if I don't eat 6 hours before I go to bed.

Steve G is correct and there have been studies done on this which I have previously posted which prove that he is correct.

In most cases it is 3 to 4 hours and this study of 21 J pouch patients who ate omelettes found it was 189 minutes, which is an average transit time of 3 hours 9 minutes:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728466/

Of course you can take imodium or antispasmodics which will slow down the bowels, or opiods, and you can easily stretch it out to 6 hours or more by messing around with peristalsis.  That's fairly easy to do.

In my own case I am going to say 3.5 - 4 hours.

If you are having rapid fire BMs after eating it's not the food you just ate. It's likely a spasmodic bowel which needs to be controlled with anti-spasmodic drugs taken 45 minutes before meals. Do this and problem is solved.

Last edited by CTBarrister

For me transit time for the first post-meal BM is also around one and a half hour after eating a meal. Sometimes (rarely) it's much shorter. If I eat spinach it can come out between a half and an hour afterwards. Normally I go 8 - 10 times a day including 2 - 4 times at night. I take my main meal around 4 or 5pm. Then I have some time left to visit the bathroom 3 or 4 times before I go to bed. I've tried to reduce the trips after eating but have not been successful so far.

WeIl, I read somewhere else in a post, that you suggested to take something like immodium (I believe) 45 min before a meal to calm things down. I tried this only once without noticing a change to my BM routine. Well, I wouldn't say this is proof or not proof of your suggestion. Therefore I might try this again at a later stage.

I'm currently starting a run with Budesonid capsules (3 mg: 1-1-1) and Mesalazine suppositories twice a day. My doc asked me to give this a try. So, for the next 6 weeks I'll be on cortisone and for the coming two weeks on Mesalazine. We'll see what's going to happen.

This week I'll have to provide a stool sample for a check on calprotectin etc. Last week I've done a glucose tolerance test which didn't show any negative results.

BTW: I only eat between noon and 7 or 8pm. So, that means that I'll have some 3 or 4 BMs before midnight and after I ate the last piece of (mostly) bread. And then 2 - 4 during the rest of the night.

Thank your for your support.

@PaulS posted:

WeIl, I read somewhere else in a post, that you suggested to take something like immodium (I believe) 45 min before a meal to calm things down. I tried this only once without noticing a change to my BM routine. Well, I wouldn't say this is proof or not proof of your suggestion. Therefore I might try this again at a later stage.

I'm currently starting a run with Budesonid capsules (3 mg: 1-1-1) and Mesalazine suppositories twice a day. My doc asked me to give this a try. So, for the next 6 weeks I'll be on cortisone and for the coming two weeks on Mesalazine. We'll see what's going to happen.

This week I'll have to provide a stool sample for a check on calprotectin etc. Last week I've done a glucose tolerance test which didn't show any negative results.

BTW: I only eat between noon and 7 or 8pm. So, that means that I'll have some 3 or 4 BMs before midnight and after I ate the last piece of (mostly) bread. And then 2 - 4 during the rest of the night.

Thank your for your support.

When you said you tried once to take immodium before a meal and it did not work, it takes time for it to work when you start a new routine. I would give it more time next time when you try a new routinel

let us know how your poop sample goes!!!

@PaulS posted:

WeIl, I read somewhere else in a post, that you suggested to take something like immodium (I believe) 45 min before a meal to calm things down. I tried this only once without noticing a change

I didn't say Imodium. I said Lomotil (Bentyl and Levsin and Donnatal are also anti-spasmodics). Imodium is an anti-diarrheal. Lomotil is an anti-spasmodic. One should not be confused with the other. Imodium is over the counter and is used to treat diarrhea. Lomotil is prescription and is used to treat excessive motility. Imodium has little or no impact on motility or a spasmodic bowel. Lomotil is designed exactly for the use I described. It's a prescription drug with side effects. Donnatal is similar with less side effects also by prescription.

I should add that Bentyl and Levsin are more commonly prescribed than Lomotil, but their side effects are intense. They made me feel like one of the slow moving Zombies in the film Night of The Living Dead. Not to be confused with the more aggressive faster moving modern Zombies in 28 Days Later.

It's really important to understand the drugs under discussion and important differences between them and how they work on your body before just popping pills. These drugs have totally different mechanisms of action. Imodium is a complete waste of time for treating motility issues.

Last edited by CTBarrister

I think I may have misspoken in my post above and Scott thank you for the correction. Bentyl, Levsin and Donnatal are the drugs most often prescribed as antispasmodics. Lomotil is an anti diarrheal (prescription) with anti-spasmodic properties. We are going back at least 25 years as to when I took these drugs so it's a bit of a jumble in my head. My memory is that Bentyl and Levsin were the first ones prescribed for a very bad spasmodic bowel I had after one of my surgeries. After being Zombified by those 2, I tried Donnatal and had less side effects with equivalent action. It was at some point after that that Donnatal was off the market for a period of time when I then took Lomotil. By then the spasmodic bowel was under control. I believe my doctor told me Lomotil was a prescription strength version of Imodium but that it had anti-spasmodic properties. Of those 4 drugs, Bentyl and Levsin are the most potent pure anti-spasmodic drugs.

Bentyl and Levsin are the go-to anti-spasmodics and I would start with them because the side effects might not be as intense for you. They get the job done taken 45 minutes before meals, side effects or not.

Last edited by CTBarrister
@PaulS posted:

For me transit time for the first post-meal BM is also around one and a half hour after eating a meal. Sometimes (rarely) it's much shorter. If I eat spinach it can come out between a half and an hour afterwards. Normally I go 8 - 10 times a day including 2 - 4 times at night. I take my main meal around 4 or 5pm. Then I have some time left to visit the bathroom 3 or 4 times before I go to bed. I've tried to reduce the trips after eating but have not been successful so far.

Yeah same with me as well, I tried to reduce trips as well but have not been successful either. But maybe that is suppose to be our baseline and I think that is pretty healthy for us if were not having any other issues.

Last edited by Former Member

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