I'm worried its going to always be like this..take-down was april 30th this year. I empty before bed, go to sleep, wake up 2 - 2.5 hours later, bathroom, back to bed..wake up again, 2 - 2.5 hours later and do it all over again. this continues until I'm up for good and have put something in my stomach which slows things down. I'm scared to take my hydrocodone meds to slow things down because i would really hate to sleep through a BM. does night time sleeping get better? i use to enjoy sleep so much but now i dread it. I almost feel like there is a connection to sleeping on my left side, right side, or my back..like something is better than the other to lay there longer?
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Have you tried Lomotil or Immodium? Neither of these will make you sleep through anything, they'll just slow things down.
You are still very early in recovery. In all likeliness this will not be the norm. But you can pretty much count on getting up at least once a night as the norm. I have only slept thru the night a handful of times. Some j pouchers do all the time though...lucky ones! The Imodium may help you a lot I would give it a try. I don't like it for myself because it makes it hard for me to empty.
Sorry, i should have put in the post that i do take 2 Lomotil (i think thats the spelling) before bed, i have changed the time anywhere from right before bed to an hour before and all that trying to find a point in time thats better, no such luck yet... 
really dont want this to be the norm
really dont want this to be the norm
Unfortunately, what the surgeons fail to tell us is that will this procedure you need a lot of patience. It does get better....hang in there. 
I had my takedown on Apr 9th and had the same issue as you for a while. Also, I don't fall asleep easily, so for me each trip meant lying awake for an hour or two. But, things have gotten better. Nowadays, I empty right before going to sleep and then I wake up maybe once to empty again. There have been a handful of nights that I have not had to wake up to go. For me, a lot also has to do with getting back the confidence that I can delay going to the bathroom. With UC i would have to rush to the bathroom if my tummy rumbled even a bit. Even now, o wake up if my tummy is making sounds or something is moving inside and once I am up I rather just go nd empty the pouch the keep wondering if I will need to go later. And, you are right about the position we sleep in making a difference. If I sleep flat on my back I have the least amount of urges to go. But, if I turn on to my right side I feel I have to go. I had this when I still had my colon. I wonder if this will ever go away.
Hope it gets better for you soon and you can enjoy a good night's sleep again!
Hope it gets better for you soon and you can enjoy a good night's sleep again!
Thanks Marianne, crossing my fingers : ). And ucwarrior I have noticed that same thing that my back seems to be the better position..I just like sleeping on my side so much more, put a pillow between my legs and I'm in heaven lol. Has your side sleeping gotten better with time?
Have you tried using Imodium instead of Lomotil? I think I remember reading from Jan (the oracle!) that Imodium improves sphincter tone in addition to slowing digestion so you're less likely to have nighttime leakage or urgency than with Lomotil.
You are doing very well for being only this far out. There is no way they prepare us for how long this surgery takes to recover from. It takes a while for the pouch to stretch out a bit and for the small intestines it was made from to learn their new job. They are use to just pushing the waste on down the line.
Take care
Take care
Depends on the night. Some nights turning on to the side doesn't bring on the urgency. I assume things are getting better...really slowly though.
Yes, please be patient.
My takedown was in 2007, and it took many years before I had a whole night in bed without having to get up. I take Immodium right before bedtime and for me that helps. Also the schedule of when I eat (and especially drink fluids) makes a big difference.
Hang in there,
Mark
My takedown was in 2007, and it took many years before I had a whole night in bed without having to get up. I take Immodium right before bedtime and for me that helps. Also the schedule of when I eat (and especially drink fluids) makes a big difference.
Hang in there,
Mark
I would be completely happy with just having to get up once a night, fine with that.
I only have a few more nights worth of Lomotil left, so when i run out ill switch to immodium and see how well i do. will any brand do or do you feel with immodium you get what you pay for?
I only have a few more nights worth of Lomotil left, so when i run out ill switch to immodium and see how well i do. will any brand do or do you feel with immodium you get what you pay for?
Okay so I'm about 10 weeks post takedown and here are the tricks that I have learned. I have a schedule where I take Citrucel 3 times a day to keep things moving smoothly and also eliminates a lot of "butt burn". I do take 2 )Lomotil before bed but it still doesn't really slow things down enough to not wake up 2-3 times a night. One great thing I've decided to do is have my last meal between 6-7pm. This helps give me time to digest and get most of my bowel movement out before I go to bed. Do not eat late you'll be doomed. If I stop eating as much throughout the day because I don't want to have so many bowel movements it causes me extreme "butt burn" throughout the night and in the morning because its basically my body just removing stomach acids. Try changing up your diet, medicine, and times you eat to see what's most effective for you. Its gonna take time, patience, and experimenting to make your new system cooperate. I also realized I have more bathroom trips in the middle of the night if I sleep im my sides. I've been sleeping on my couch for months because it helps my body pains and also less bathroom trips. My wife hates it because she wants to sleep with me but you have to put you number 1 and do what works for you. For those who had a surgeon that didn't prepare you for all this I feel bad. My surgeon was great letting me know what I was getting myself into and he's been there ever since. Anyway good luck we are all here for support.
Sorry to hear you're having these problems! I'm similar to phonix, metamucil twice a day, stop eating around 6pm, try to get my liquids mostly before 6pm with only small amounts after, and immodium right before bed. Are you liquid when you go to the bathroom in the middle of the night? The fiber will help thicken you, which will be great if you're liquid, but I'm not sure it'll be much good if you're already pretty solid. Just depends on your situation I guess - good luck with the adjustments and hope you get better soon.
Polyps, its sometimes more liquid but tends to be more early in the morning that starts..like 3:00..last night however before i went to bed, first i prayed to sleep, then took two immodium, half of hydrocodone pill, then an hour later i took my cipro and flagyl (pouchitis, have a month treatment to finish) i woke up 3 times, twice to actually use the bathroom, once at 1:30, another at 5:30ish, then again at 6:30 but i was waking up at 6:50 so i laid back down and able to get through it.
it hurts to go to the bathroom sometimes as well, is that because of the immodium? i feel like im pushing so hard sometimes.
it hurts to go to the bathroom sometimes as well, is that because of the immodium? i feel like im pushing so hard sometimes.
Yeah, I've never had pouchitis, so I'm obviously out of my league here, because I've never taken cipro or flagyl. I'd ask your surgeon/doctor what they recommend. All I was saying is that if you're liquid, 1 tbsp of sugar free metamucil mixed in .5 cups water taken twice a day will thicken you. Whether that's still recommended if you have pouchitis is a another matter though. But if you're already solid, not sure you need to go there. I take immodium, and in the mornings it sometimes feels like "incomplete emptying." Basically, I'll wake up once in the night at like 11pm, and then sleep for 7 hours, but then wake up and use the bathroom maybe 2 times in 2 hours. But I've never had pain associated from immodium (I just take one tablet crushed in yogurt prior to bed). Sorry if that's not super helpful - hope your situation gets better soon.
Sympathies. I am 2.5mo post-takedown and I rely entirely on narcotics (I find oxycodone works better than hydro in my case) to get more than two or three hours in a row. It's a simple equation for me: when I use it, I sleep six hours +/-1. When I don't, my nights are just like yours.
Setting aside for the moment whether long-term narcotic use is a good idea, or whether your doctor will allow it (more on those topics below), does hydrocodone really zonk you out so much that you fear "sleeping through a BM"? In my case, there's no chance of that. On 10mg, I sleep well and comfortably, but when the pouch strikes, I'm wide awake. This is even true on the few occasions where I don't make it 6h. Have you had other accidents?
So here's a suggestion: Get yourself some Depends and/or chucks (disposable "water"proof pads) to sleep in/on, and try it for a couple of nights. You may surprise yourself.
Now, IMHO, the stigma associated with long-term narcotic use is overblown and unwarranted when used to slow digestion. As I understand it, whereas the pain releiving and psychotropic effects diminish over long usage, the digestive effects do not. And, again IMHO, addiction is irrelevant when a medical need exists - though there's little risk of developing an addiction if you're only using it once or twice a day. This all assumes you are lucky enough to have a doctor who agrees and is willing to continue prescribing narcotics long-term.
I will also echo notes from this thread and others: Make your last meal of the day a small one, and eat it at least 4h before bedtime. Take a motility reducing drug (Lomotil, Immodium, tincture of opium) up to 1h before bedtime. Use psyllium fiber (e.g. Metamucil) to thicken, slow, and de-sting-ify. (NB: I found it is possible to overdo the psyllium. I was using the "tablespoon dose" powder, 1Tbsp 3x/day: the extra volume caused extra BMs, which is obviously counterproductive. At this point, I use capsules, four before each meal, with much better results.)
Next: sleeping position. I'm right there with you. I go longest when I sleep on my back. I had to learn this and get used to it - I also prefer side-with-knee-pillow. One thing that helped here: Yoga. Most yoga classes end with a position called Savasana. To the uninitiated, this looks like "lying on your back". But (as with all yoga) the subtleties of the positioning have been carefully studied and tuned over generations. To wit, I have always had trouble with limbs falling asleep, joints aching, etc. during sleep; in a proper Savasana, I don't. (I usually don't even need a pillow.)
However, I have noticed that you can fight it and get used to it. It used to be that I couldn't lay on either side at all, even for a couple of minutes. But I have found more and more that, if you ignore (okay, fight off, fists clenched and teeth gritted) those first few waves of cramps/urges, sometimes, if you're lucky, they'll fade and disappear for long enough to get you some rest. In my case, if I get a real good empty, I can usually get a few hours on my left side. Right side seems slightly worse, but probably no statistical significance.
I think this one is going to depend on the exact configuration of your specific pouch. My theory here is that it has to do with the way the pouch deforms and stretches depending on your orientation: in some positions, it may squeeze to a reduced capacity; it may tug on your anastamosis; it may increase contact of stool with spots of irritation (especially in your pouchitis case).
Pushing: ye gods, don't do it. I struggle so hard with this (so to speak). I spent my whole life with tenesmus (though I didn't have a name for it until my diagnosis), so I have decades of pushing habits ingrained in my brain. Even now, with the diseased colon gone, I have tenesmus - never feeling empty, thinking if I can just push hard enough, I'll get there.
This is poison. This will cause a vicious cycle that will delay your recovery and could lead to other complications. It may even be the cause of your pouchitis. Here's my (non-medical, anecdotal) explanation: When you push, you cause the tissues to become inflamed. Inflamed tissues are more sensitive, and will result in greater feelings of urgency from any pressure or contact from gas or stool. It doesn't take much until the inflammation can cause urgency all by itself (without pressure/gas/stool). You respond to the urgency with more pushing, and so on. The pushing and inflammation can (and will) lead to hemorrhoids and similar structures at any point along the pouch and exit route. Now you have stool coming in contact with open wounds. Infection (which may be diagnosed as "pouchitis" in some cases) becomes a question of when, not if.
Believe me when I say that this is the hardest part of my recovery: the utter iron-willed discipline required for me NOT to push. Especially when I'm experiencing tenesmus, which I still do, regularly (no pun intended). You will become frustrated because you'll FEEL like you should push, and you'll discipline yourself not to, and then you'll get up, and the urge will hit again right away, and sometimes you'll actually even produce. "See - there WAS stool there - I just wasn't pushing." To break the cycle, you need to ignore these "secondary urges". It will only take a few days for them to subside. In the meantime, ask your doctor for some hydrocortisone/pramoxine cream to help with the inflammation.
Best of luck to you. I'll be following your case with interest.
Setting aside for the moment whether long-term narcotic use is a good idea, or whether your doctor will allow it (more on those topics below), does hydrocodone really zonk you out so much that you fear "sleeping through a BM"? In my case, there's no chance of that. On 10mg, I sleep well and comfortably, but when the pouch strikes, I'm wide awake. This is even true on the few occasions where I don't make it 6h. Have you had other accidents?
So here's a suggestion: Get yourself some Depends and/or chucks (disposable "water"proof pads) to sleep in/on, and try it for a couple of nights. You may surprise yourself.
Now, IMHO, the stigma associated with long-term narcotic use is overblown and unwarranted when used to slow digestion. As I understand it, whereas the pain releiving and psychotropic effects diminish over long usage, the digestive effects do not. And, again IMHO, addiction is irrelevant when a medical need exists - though there's little risk of developing an addiction if you're only using it once or twice a day. This all assumes you are lucky enough to have a doctor who agrees and is willing to continue prescribing narcotics long-term.
I will also echo notes from this thread and others: Make your last meal of the day a small one, and eat it at least 4h before bedtime. Take a motility reducing drug (Lomotil, Immodium, tincture of opium) up to 1h before bedtime. Use psyllium fiber (e.g. Metamucil) to thicken, slow, and de-sting-ify. (NB: I found it is possible to overdo the psyllium. I was using the "tablespoon dose" powder, 1Tbsp 3x/day: the extra volume caused extra BMs, which is obviously counterproductive. At this point, I use capsules, four before each meal, with much better results.)
Next: sleeping position. I'm right there with you. I go longest when I sleep on my back. I had to learn this and get used to it - I also prefer side-with-knee-pillow. One thing that helped here: Yoga. Most yoga classes end with a position called Savasana. To the uninitiated, this looks like "lying on your back". But (as with all yoga) the subtleties of the positioning have been carefully studied and tuned over generations. To wit, I have always had trouble with limbs falling asleep, joints aching, etc. during sleep; in a proper Savasana, I don't. (I usually don't even need a pillow.)
However, I have noticed that you can fight it and get used to it. It used to be that I couldn't lay on either side at all, even for a couple of minutes. But I have found more and more that, if you ignore (okay, fight off, fists clenched and teeth gritted) those first few waves of cramps/urges, sometimes, if you're lucky, they'll fade and disappear for long enough to get you some rest. In my case, if I get a real good empty, I can usually get a few hours on my left side. Right side seems slightly worse, but probably no statistical significance.
I think this one is going to depend on the exact configuration of your specific pouch. My theory here is that it has to do with the way the pouch deforms and stretches depending on your orientation: in some positions, it may squeeze to a reduced capacity; it may tug on your anastamosis; it may increase contact of stool with spots of irritation (especially in your pouchitis case).
Pushing: ye gods, don't do it. I struggle so hard with this (so to speak). I spent my whole life with tenesmus (though I didn't have a name for it until my diagnosis), so I have decades of pushing habits ingrained in my brain. Even now, with the diseased colon gone, I have tenesmus - never feeling empty, thinking if I can just push hard enough, I'll get there.
This is poison. This will cause a vicious cycle that will delay your recovery and could lead to other complications. It may even be the cause of your pouchitis. Here's my (non-medical, anecdotal) explanation: When you push, you cause the tissues to become inflamed. Inflamed tissues are more sensitive, and will result in greater feelings of urgency from any pressure or contact from gas or stool. It doesn't take much until the inflammation can cause urgency all by itself (without pressure/gas/stool). You respond to the urgency with more pushing, and so on. The pushing and inflammation can (and will) lead to hemorrhoids and similar structures at any point along the pouch and exit route. Now you have stool coming in contact with open wounds. Infection (which may be diagnosed as "pouchitis" in some cases) becomes a question of when, not if.
Believe me when I say that this is the hardest part of my recovery: the utter iron-willed discipline required for me NOT to push. Especially when I'm experiencing tenesmus, which I still do, regularly (no pun intended). You will become frustrated because you'll FEEL like you should push, and you'll discipline yourself not to, and then you'll get up, and the urge will hit again right away, and sometimes you'll actually even produce. "See - there WAS stool there - I just wasn't pushing." To break the cycle, you need to ignore these "secondary urges". It will only take a few days for them to subside. In the meantime, ask your doctor for some hydrocortisone/pramoxine cream to help with the inflammation.
Best of luck to you. I'll be following your case with interest.
I have not posted in a while but just want to say that my experiences mirrors those described here. I only sleep for a few hours and wake to rumbling in ny abdomen. I find that position is very important- like others flat on my back is best- sometimes when I wake I have no pain and turning to my side instantly causes pain and the urge to empty. I also find it hard to get back to sleep due to the cramping feeling after emptying. Ithink it is just more noticable at night. Often sitting up and bending forward eases the discomfort and allows me to get back to sleep. Also for me the problem is getting cold when I get up in the night which makes it harder to get back to sleep_ emptying is not quick as straining makes the after pains worse- so when I get up I flick on my electric blanket switch and then when I finally get back to bed it is at least warm ( it works quickly becauase the bed is warm when I first wake so it is not heating up from scratch).
I had take down Jan 2011
I had take down Jan 2011
sorry typing error - takedown Jan 2012
My deepest sympathies. I had the same issues for years, with the addition of accidents. Now, rare accidents, and up maybe once/night.
I think getting pouchitis/cuffitis/fistula under control helped the most, but I also added 2 loperamide (immodium) at bedtime - I buy these generic at either Target or Walmart and IMO they work even better than the prescription immodium I previously used. I also take a probiotic at bedtime and eat homemade yogurt during the day.
Also, if possible, try to keep carbs/sugars at a minimum if you can at this point. Also try to avoid drinking too much water in the evening hours - get your liquids earlier in the day/afternoon.
Have you been scoped recently? Wondering if you might have narrowing or a stricture which can make it more difficult to empty completely.
I think getting pouchitis/cuffitis/fistula under control helped the most, but I also added 2 loperamide (immodium) at bedtime - I buy these generic at either Target or Walmart and IMO they work even better than the prescription immodium I previously used. I also take a probiotic at bedtime and eat homemade yogurt during the day.
Also, if possible, try to keep carbs/sugars at a minimum if you can at this point. Also try to avoid drinking too much water in the evening hours - get your liquids earlier in the day/afternoon.
Have you been scoped recently? Wondering if you might have narrowing or a stricture which can make it more difficult to empty completely.
Takedown was back in April and am still getting up 3-6x/night and still occasionally have an accident at night (last two nights are the most recent). Getting very tired of this and don't see things getting better (daytime movements are still high too - 7-12x/day). I've been on Flagyl (which worked okay) but can no longer take due to numbness in feet/hands, Cipro (took with Flagyl - Dr. took me off it at the same time as he took me off Flagyl). Currently on one 100mg Doxycycline, Opium tincture (3 drops 3x/day) and 1tb 2x/day of Konsyl fiber. Also began taking 3 immodium before bed. What else can I try? Augmenten?
As for history after take down I had three procedures to correct stricture (finally the 3rd time a different surgeon actually snipped away some tissue as opposed to just widening it). I have had a scope and it showed minor Pouchitis but was healing (back in early Dec). Blood tests and CT scan ruled out Crohn's. Surgeon here in DSM says I may be one of those 10% taht the pouch doesn't play nice with the body. I don't want to go back to an external but I also don't want to be dependent on being close to a bathroom all the time. And I'm getting tired of wearing Depends at night.
As for history after take down I had three procedures to correct stricture (finally the 3rd time a different surgeon actually snipped away some tissue as opposed to just widening it). I have had a scope and it showed minor Pouchitis but was healing (back in early Dec). Blood tests and CT scan ruled out Crohn's. Surgeon here in DSM says I may be one of those 10% taht the pouch doesn't play nice with the body. I don't want to go back to an external but I also don't want to be dependent on being close to a bathroom all the time. And I'm getting tired of wearing Depends at night.
Urbhuskr,
I live in the DSM area too and had my surgeries here too. Please PM me as I was referred to Mayo by my GI when my GI and surgeon couldn't clear up my chronic cuffitis with the traditional treatment.
The traditional treatment for pouchitis is not working for you so you probably need to go see an IBD specialist as well. The surgeons here are good but not as good with problems as specialists that only deal with IBD and j-pouch patients. Please don't go back to an external bag until you have checked out all your options. They do not see as many cases here as they do in Rochester where they are IBD specialists.
I also had several cases of c.diff and what was thought pouchitis and could not take cipro. I got c.diff from taking cipro when I had my colon. Augmentin does work better for me than flagyl.
I found out at Mayo I have IPS along with my chronic cuffitis and have a treatment plan that is working.
I live in the DSM area too and had my surgeries here too. Please PM me as I was referred to Mayo by my GI when my GI and surgeon couldn't clear up my chronic cuffitis with the traditional treatment.
The traditional treatment for pouchitis is not working for you so you probably need to go see an IBD specialist as well. The surgeons here are good but not as good with problems as specialists that only deal with IBD and j-pouch patients. Please don't go back to an external bag until you have checked out all your options. They do not see as many cases here as they do in Rochester where they are IBD specialists.
I also had several cases of c.diff and what was thought pouchitis and could not take cipro. I got c.diff from taking cipro when I had my colon. Augmentin does work better for me than flagyl.
I found out at Mayo I have IPS along with my chronic cuffitis and have a treatment plan that is working.
P.S.
I also had problems with frequency etc.
You do not need a physician referral to go to Mayo and I can post the information again.
I also had problems with frequency etc.
You do not need a physician referral to go to Mayo and I can post the information again.
Actually all my surgeries (colon removal, large, infected hematoma removal a week after colon removal & 2 stricture procedures) have taken place at Mayo...except the last stricture surgery. That was done in DSM (Dr. Michael Page) and he actually cut scar tissue instead of sending me home to self dilate. Things were getting better on Flagyl but since they have taken me off not so much. I failed to mention I was tested for c-diff and that was negative. My GI doc (Reyes here in DSM) had gotten me an appt in Rochester for early December but they were going to do exactly what the Iowa Clinic had done a week earlier - scope and cat scan. I didn't see any reason to spend time and money to have the exact same tests done on me. Reyes will be back in town (after two week in the Philippines helping out with relief efforts) and we'll have a conversation on next steps. Personally I want to look at Augmentin and/or Cipro before heading back to Mayo.
Dr. Page was the surgeon that did an excellent job on my surgeries so you did well in trusting him. He trained at Cleveland Clinic and the GI that scoped me at Mayo the first time said I had the best j-pouch he'd seen in 5 years. I'm sure he was joking but I have no complaints about having my surgery done locally.
My GI Dr. O'Brien sent me to Mayo, where he trained, when he couldn't get my cuffitis to go away after 5+ months of treatment with canassa and/or anucort. He said he was a generalist and I needed to see an IBD specialist. Maybe your local GI sees a lot j-pouch IBD cases but we are few, which is good I guess. I think it makes sense to try treatment at home first too. Hopefully it will solve your problems.
I had c.diff with my cuffitis and it had gone away by the time I went to Mayo. I was diagnosed with chronic cuffitis, and IPS. I saw the doctor I first saw in 1998 for a second opinion of my initial diagnosis. He is Dr. Edward Loftus Jr. who is now the Director, Inflammatory Bowel Disease Clinic along with some other titles. I think he's remarkable so highly recommend him but am sure there are many other great GI's there. Your local GI probably has some that he works with. He asked questions that I swear only a person with a j-pouch would ask. He has designed a good treatment plan for me.
I mention the IPS as it is sometimes difficult to diagnosis. I had several recurring bouts of c.diff or pouchitis where I was prescribed Flagyl without the benefit of a c.diff stool test or scope first. They all have similar symptoms. I think I never had pouchitis as I can now tell the difference between cuffitis, IPS, them together and c.diff.
I take VSL#3DS for pouchitis prevention a s.boulardii for c.diff prevention but neither when I take Augmention, which is what I take for IPS flares. I can't take CIPRO as it caused c.diff once when I had a colon. Flagyl doesn't sit well with me plus I already have neuropathy in my feet. So Augmention is the antibiotic I take.
When I am having an IPS flare gravity is my worse enemy. I usually only need to get up a few times during the night but I also take Loperamide, up to 8 a day, even when I am not having a flare.
I hope all works out well and you do not to go to Mayo's or need further surgery.
My GI Dr. O'Brien sent me to Mayo, where he trained, when he couldn't get my cuffitis to go away after 5+ months of treatment with canassa and/or anucort. He said he was a generalist and I needed to see an IBD specialist. Maybe your local GI sees a lot j-pouch IBD cases but we are few, which is good I guess. I think it makes sense to try treatment at home first too. Hopefully it will solve your problems.
I had c.diff with my cuffitis and it had gone away by the time I went to Mayo. I was diagnosed with chronic cuffitis, and IPS. I saw the doctor I first saw in 1998 for a second opinion of my initial diagnosis. He is Dr. Edward Loftus Jr. who is now the Director, Inflammatory Bowel Disease Clinic along with some other titles. I think he's remarkable so highly recommend him but am sure there are many other great GI's there. Your local GI probably has some that he works with. He asked questions that I swear only a person with a j-pouch would ask. He has designed a good treatment plan for me.
I mention the IPS as it is sometimes difficult to diagnosis. I had several recurring bouts of c.diff or pouchitis where I was prescribed Flagyl without the benefit of a c.diff stool test or scope first. They all have similar symptoms. I think I never had pouchitis as I can now tell the difference between cuffitis, IPS, them together and c.diff.
I take VSL#3DS for pouchitis prevention a s.boulardii for c.diff prevention but neither when I take Augmention, which is what I take for IPS flares. I can't take CIPRO as it caused c.diff once when I had a colon. Flagyl doesn't sit well with me plus I already have neuropathy in my feet. So Augmention is the antibiotic I take.
When I am having an IPS flare gravity is my worse enemy. I usually only need to get up a few times during the night but I also take Loperamide, up to 8 a day, even when I am not having a flare.
I hope all works out well and you do not to go to Mayo's or need further surgery.