Do j-pouchers absorb nutrients the same way or as much as a non-j-poucher? I am concerned that I am not getting all the nutrients I need.
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Just about all nutrition is absorbed in the small intestine, and J-pouchers usually have their entire small intestine. There might be some effect on absorpotion from the portion of the terminal ileum (the last part of the small intestine) used to fashion the J-pouch, but for most folks this is a non-issue.
That being said, some folks here seem to have difficulty with certain nutrients. The most common one I've noticed is iron. I suspect (though I can't be sure) that this could be the result in some cases of a transit time that's just too short. If you have diarrhea absorption of nutrients will be disrupted, whether you have a J-pouch or not.
That being said, some folks here seem to have difficulty with certain nutrients. The most common one I've noticed is iron. I suspect (though I can't be sure) that this could be the result in some cases of a transit time that's just too short. If you have diarrhea absorption of nutrients will be disrupted, whether you have a J-pouch or not.
I have had problems with iron for years. I take Iron- ferrous gluconate.
Last year I began having problems with vitamin D. I now take 5000IU of vitamin D extra a day on top of my multivitamin and calcium plus d.
Last year I began having problems with vitamin D. I now take 5000IU of vitamin D extra a day on top of my multivitamin and calcium plus d.
I also found myself vitamin D deficient (and take 5000 units daily), but that seems to have become extremely common in the general population, too, so it may have nothing to do with J-pouches.
My surgeon has also warned that B vitamins should be monitored early in the process to make sure the levels are high enough.
"Early in the process" is a whole different thing, I think, and good surgeons pay close attention to this. Many folks having J-pouch surgery have been chronically ill and/or on long-term medications with significant side effects (including nutritional side effects). The surgery itself also takes its toll on the body, sometimes quite significant. I'd guess that the majority of J-pouchers (who were ill prior to surgery) have improved nutrition in the long term.
Originally my surgeon informed me that if I could gain weight that it would be a sign that I was absorbing enough...he was sort of right...for a while.
It took a year + to start gaining weight (then I couldn't stop). But over the years I had problems with various deficiencies. I took part in a Princess Margaret Hospital study where they made us eat certain diets and then tested our stools..We had control tests with our 'coloned bretheren' and they compared the % of absorbtion (how? I do not wish to know!)...they were really pleased to be able to use a k poucher because my transit time was extraordinary at first.
That said, I take gummy multi-vits, iron, B's & D +Cal and my obligatory collagene (personal needs).
Most of my blood work is pretty good, I eat a balanced diet (ignore my sugar and other binges) and eat tons of dried fruits and nuts plus fresh herbs which are all trace mineral and vitamin bombs.
If you find yourself inordinately tired then my 1st instinct is dehydration then iron or B's. Bloodwork is the only way to check.
Sharon
It took a year + to start gaining weight (then I couldn't stop). But over the years I had problems with various deficiencies. I took part in a Princess Margaret Hospital study where they made us eat certain diets and then tested our stools..We had control tests with our 'coloned bretheren' and they compared the % of absorbtion (how? I do not wish to know!)...they were really pleased to be able to use a k poucher because my transit time was extraordinary at first.
That said, I take gummy multi-vits, iron, B's & D +Cal and my obligatory collagene (personal needs).
Most of my blood work is pretty good, I eat a balanced diet (ignore my sugar and other binges) and eat tons of dried fruits and nuts plus fresh herbs which are all trace mineral and vitamin bombs.
If you find yourself inordinately tired then my 1st instinct is dehydration then iron or B's. Bloodwork is the only way to check.
Sharon
I am B12 and Vitamin D deficient, but so is my husband, who retains his colon. But, we are both approaching 60 and both have IBD, so we have risk factors.
Having a j-pouch is by no means any guarantee that you will not absorb nutrients properly, as Scott noted, most nutrient absorption takes place in the small intestine. But, there are many factors that affect nutrient absorption. Some may be related to having a j-pouch (like chronic pouchitis), some are not.
Jan
Having a j-pouch is by no means any guarantee that you will not absorb nutrients properly, as Scott noted, most nutrient absorption takes place in the small intestine. But, there are many factors that affect nutrient absorption. Some may be related to having a j-pouch (like chronic pouchitis), some are not.
Jan
Ever since my j pouch I do not absorb iron at all. I have to go for iron infusions to keep my levels up. Oral iron does nothing because I just don't absorb it. I have learned that many j pouchers deal with iron deficient anemia.
From the time I got my J Pouch in 1992, I was told by my surgeon that it will be a good idea to permanently take chewable multiple vitamins, this because they said my nutritional absorption may be different after surgery. At the time Flintstones was recommended to me. Since that time, in 2010, I had a bone density scan and was discovered to have osteopenia which was blamed on prolonged use of Prednisone. I was also discovered to be on the low end of what is acceptable on vitamin D. So I started taking calcium and vitamin D supplements and fish oil as well as the chewable vitamins (I now take Centrum for adults 50+).
My blood labs have been pretty good since then, but per my PCP, we are going to do a repeat bone density scan next year to assess where I am with the osteopenia. It was mostly in my left, non-dominant forearm.
The J Pouch is a part of your ileum - more correctly it is made out of a part of your ileum which, but for the surgery, would have been absorbing nutrients moving along in a straight line down your ileum. But now that part of ileum is a pouch storing stool, and in my case it's also inflamed. So it is theoretically impossible, as a matter of basic science and physics, for your shortened ileum with J Pouch after surgery to absorb nutrients as well or as efficiently as the intact ileum prior to surgery. It isn't the same ileum that once was, inside of any of us. And that portion of it used to construct the J Pouch cannot be processing nutrients as efficiently, if it is diseased and is also storing stool. I always assumed that this was the factual basis for the advice I got from my surgeon.
My blood labs have been pretty good since then, but per my PCP, we are going to do a repeat bone density scan next year to assess where I am with the osteopenia. It was mostly in my left, non-dominant forearm.
The J Pouch is a part of your ileum - more correctly it is made out of a part of your ileum which, but for the surgery, would have been absorbing nutrients moving along in a straight line down your ileum. But now that part of ileum is a pouch storing stool, and in my case it's also inflamed. So it is theoretically impossible, as a matter of basic science and physics, for your shortened ileum with J Pouch after surgery to absorb nutrients as well or as efficiently as the intact ileum prior to surgery. It isn't the same ileum that once was, inside of any of us. And that portion of it used to construct the J Pouch cannot be processing nutrients as efficiently, if it is diseased and is also storing stool. I always assumed that this was the factual basis for the advice I got from my surgeon.
All very true, CT! But, I did want to point out that of the typical 15-20 feet of small bowel, only 6-12 inches is used for the pouch, so it really is a quite small percentage. Plus, at least in the U.S., malnutrition due to inadequate intake is rare, since most of us consume far more than is required for health. So, even if it is not as efficient, in most cases having a j-pouch does not mean inadequate nutrition absorbed.
Still, it is another factor added to the pile of various risks, including age.
The main thing is to be aware of the possibility, without assuming you are at high risk.
Jan
Still, it is another factor added to the pile of various risks, including age.
The main thing is to be aware of the possibility, without assuming you are at high risk.
Jan
I have also had vitamin deficiency before and after my surgery due to UC. It took a long time before I was vitamin deficient. I take multivitamin, VitD, magnesium, calcium, B12 shots, prolia for osteoporosis, due to UC and I am iron deficient can not take iron because of constipation. I do feel fatigued most of the time. It took awhile before my blood work started coming back normal. I was a very active before my UC. The disease took a lot out of me. I would love to be able to obtain my vitamins thru food but my digestion will not allow me. I am on antibiotic every day because of chronic pouchitis. It has changed my life like most of you. I am truly happy that I found this web site so I can read and share every ones post. I also feel that I am not alone
because no one really knows what you go thru. I am very thankful that I am here. Health to all Grace
because no one really knows what you go thru. I am very thankful that I am here. Health to all Grace
Thank you everyone! I am glad I have my j-pouch but I feel it can be tempermental. Since getting my j-pouch in 2002, I feel I get sicker more often. Especially with gastroenteritis.