I am 5 years out from my j-pouch surgery. I have not had major problems, except the last 3 years , I've had small bowel obstructions every fall - the symptoms were miserable bloating and cramping, vomiting. Each time my GI has had me go to the hospital, where I was rehydrated via IV, had all the tests (CAT or MRI, X-ray, scoping), and in each case the obstruction cleared on its own after a couple days. The GI who has been in charge of me in the hospital all 3 times explains it as a kink/twist that happens in the small bowel, and says at this point there's not much to do to prevent it and it could never happen again or it could happen next year, etc. He doesn't think diet has much to do with it. My regular GI (who is very experienced and well-regarded in the field, as is the one who sees me when I'm in the hospital) just did a scoping to see how everything was doing and said my pouch looks terrific. He says I need to stay away from insoluble fiber and go for soluble (per his advice I take Metamucil, which seems good for me). Lately I've found that eating an "apple a day" seems to be very good for my bowel function, and I mentioned this to him. He said I was "playing with fire" because, he said, apples are high in insoluble. At home I googled sources of soluble fiber and see that apples actually are pretty good sources of soluble fiber, along with insoluble. What should I believe? Maybe my very good gastroenterologist does not know that much about diet? It's confusing. I am eager to avoid another small bowel obstruction, and/but I also am eager to keep my bowel functioning well. Any advice?
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Peel the apple.
A lot of the goodness is in the skin, if you can eat apples comfortably I wouldn't worry about it. For what it's worth I eat apples daily. Also for what it's worth I don't seem to be able to take suitable fibre, not psyllium, not metamucil and not benefibre. In fact I'm starting to think I'd be better off without banana too. In still playing with this, but maybe I'm an enigma lol
Scott F posted:Peel the apple.
I asked my GI about that, and he said it didn't matter, the apple itself was a problem! I just wonder if even very good doctors are not educated re diet.
Diet really doesn’t have much to do with obstructions, as your hospital GI said. Once the small bowel narrows, though, for reasons having nothing to do with diet, then larger food fragments, like insoluble fiber, may get trapped first. If apples make your bowel function better then you probably ought to eat them, IMO.
You’ve gotten conflicting advice from two gastroenterologists. You might as well follow the path you like better.