yes sodium depletion can lead to dehydration even if you are drinking plenty of water, so sometimes adding in salt itself and or including a sports drink product which will add in electrolytes will help mitigate that.

I tend to start to feel tired, headachy, see 'stars' or get achy in the joints...Then I realise that I haven't had enough to drink that day...

I was never a salt eater but have since learned how important it is.

Sharon

I was put on a mandatory high sodium diet the first 30 days after my takedown at Mount Sinai Hospital in NYC which was a top J Pouch facility then and now.  Ate lots of potato chips and drank V-8 juice which has copious amounts of sodium. I had believed it was the medical standard of care to increase sodium intake, ESPECIALLY right after takedown, and I don't know of any information to the contrary.  I have actually craved salt since J Pouch surgery.  You will dehydrate more rapidly in heat and humidity if sufficient electrolytes are not consumed.  The colon was responsible for absorbing electrolytes and when the colon is removed, the body needs more, although the J Pouch somewhat adapts to the colon's function but never completely.  These are all biological facts, not opinions.

Prior to having a J-pouch I never added salt to anything.  Not so anymore!  I crave salt!

I eat so much salt I'm just glad I have low blood pressure!

I normally used iodized salt but as part of my thyroid cancer treatment which included radioactive iodine, I was put on a low iodine diet for 23 days and was forced to used non-iodized "table salt."  It definitely has a much sharper taste than iodized salt, although perhaps that was due to the brand I purchased (Morton).

As for the OP's statement that more salt is needed for a J Pouch "is contrary to all advise I have heard", all advise I have heard is the exact opposite, included but not limited to being put on a MANDATORY high sodium diet after takedown by my surgeon.  Potassium consumption is also important- I had very low potassium levels after colectomy and had to be given liquid potassium (infused potassium wasn't the standard of care at that time, although I believe that may have changed).  Very low potassium levels can result in cardiac arrest.  Blowing off electrolytes after surgery can result in a host of health issues including severe dehyrdration.

I am going to make a wild guess here that Bill, when he said it was contrary, was not talking about jpouch health, but heart health. it seems he is retired so I will venture that he is older and perhaps as such might be faced with heart and or blood pressure issues.

I was equally surprised at the assertion juxtaposed to jpouch health. hopefully we've put the confusion about salt to bed.  

as I age into the age group that tends to be more aware of blood pressure I wonder whether my generous consumption of salt will be deleterious.

Yes blood pressure at my age a factor. My understanding for Jpouch is sodium is depleted from excess BMs.

Yes, unless you specifically have a high blood pressure issue due to water retention, there is no need to limit salt. It is the general population where it is recommended not to add additional salt in the diet. This is particularly true for those who tend to add salt at the table, mostly out of habit and an acquired taste for salty foods.

That said, there may some of us who need to restrict salt, but it should be on a case-by-case basis.

Jan

so if I understand you correctly Bill, you've been warned about your salt intake by a cardiologist or PCP because of blood pressure issues? if that's the case then you need to compare notes or have your docs compare notes and come to a happy resolution.

that's actually an interesting question, I don't know, maybe someone else does, why, if its because of loose stools, or poor absorption or a combination. but the bottom line is dehydration in the form of loss of water retention from the absence of your colon and concomitantly potential electrolyte imbalance, some of which can be directly mitigated by simply adding salt is something that you have to be cognizant of. pernicious dehydration is one of the biggest dangers that we can control without a colon, but we do or at least I have to think about it.

Are there a lot of pouchers out there who have low blood pressure?

It does not run in my family and yet there are times when I dip really, really low (to the point that they won't let me out of the hospital)  around 90/60 or less...is it a loss of sodium thing? Could it be why we are sometimes so very tired?

Sharon

Sharon, I was always a 100/70 kind of person until I lost weight from UC. My bp dropped and continued to drop after my surgeries, perhaps from chronic dehydration. Since my perm ileo, I'm back to 110/70 and my weight is up.  I do believe that we - bowel disease sufferers, K and J pouch, etc - have some degree of chronic dehydration and maybe that contributes to the low bp. My "Madonna" arm veins, pre blood donation, are gone. 

Oh, BTW, I have always craved salt so I don't know if I actually crave it more now but I am thrilled that I was told to use it!

Dehydration, so yes maybe sodium depletion, might be a contributing factor to low blood pressure readings.

I learned this when one time during a bad pouchitis flare, the triage nurse in the ER rushed me into a room when she couldn't get a BP at all. Apparently a clear sign I was severely dehydrated. boy was that exciting, got two IV's started and a room full of people wondering if I was going to need further attention.

Yes, definitely. I think many of us tend toward chronic, subclinical dehydration. All is OK unless something happens like pouchitis or other illness, or even a hot day with moderate activity. You can go from doing fine to bottoming out your BP pretty quick. I got some virus or something and the next thing I knew I was in the ER with 2 liters of saline running in over 15 minutes. They were rather perplexed that I was as coherant as I was. I guess my brain was used to being dry...

Jan

Funny how we 'adapt' to this new 'normal'...stay lucid when others would blink out.

I still see 'stars' a lot...get the dizzies, the light headedness, the sudden 'need to sit down Now!' feeling (especially hot days in crowded subways and buses).

I was never a salt eater (mom had ediopatic adema (sp?) so we were all on low salt/diuretic diet) and I continued until I found this site and realized that yes, we need more salt.

I never pass out completely but tend to wilt a lot.

Sharon