Usually the gut movement starts few hours post takedown. Mostly nothing but dark green liquidy output comes through. I started eating food the next day and pooing the same. Start walking as much as you can. Do kegels alot-alot. I still do them. They'll strengthen the muscles at bottom. Get a good protectant cream like ilex paste/sudocrem and start applying it regularly if you're going often. There are no set rules everyone's recovery is different. I was doing 10-15 trips for the first few weeks so the butt burn was equally bad. Get a bidet and soft tissues. Never ever rub the bottom with tissues. Once the pouch is a little stable you can add fiber supplements to thicken the output. Many folks use imodium from start to slowen down things.

Eat foods like bananas, sweet potatoes, breads, butter, nut butter( smooth if you can tolerate them) , yoghurt, egg whites, chicken, turkey, fish in heaps. Except nut butters none of the foods have ever caused me any issues

Stay away from fresh fruits/vegetables for a couple of weeks. I still cannot do a big serve of salads. Don't eat whole nuts or foods with a skin. Dairy is a personal choice. I can do dairy so I've been drinking milk 2-3 glasses since takedown.

Stay away from processed foods, artificial sugars and fried foods for a few weeks. Sugar still kills my pouch . Anytime I consume it in large amounts the urgency increases.

You can add multivitamin tablets, zinc supplement and other after consulting your GI. They'll help balance the body's nutrient levels.

Wish you a quick recovery 👍

Rest and don’t take it too fast. I just had the same surgery on the 20th. Don’t get discouraged if your healing does not go as planned. I figured I would have a quick recovery and be out in no time. It took me 11 days and I only started eating yesterday. Take it slow and be patient. Chew lots of sugar free gum and when you get to eating be very slow and chew very very well. Remember this is the big surgery it may take a while for your body to recover. Good luck!

Hello Andrina, glad to hear your second step is completed.  The only thing I remember from this step was the annoying bridge that I had for the stoma.  Not sure if you have that also.  It made it more of a challenge when changing bags, but it was soon gone, about 2 weeks after surgery.  I think I remember the output being more, or maybe just because of it now being a loop instead of an end ostomy.  Also, I believe I was on the low residue diet again fro a few weeks.   The nice thing is I didn’t have it long, 8 weeks, and then takedown.  I’m not sure if I did anything different from when I had the first step. Good luck with recovery and your final surgery.

Welcome to the JPouch club.

For tips, take it slow and easy. You just had major surgery and as was explained to me, it's like a boxer went a few rounds on your insides.

Do you have a loop-ileo or did they complete everything in 2 steps?  I had 3 surgeries (colectomy, Jpouch, and then takedown).

If you have a loop-ileo, the output from that will be more liquid than your end-ileo.

If you went straight to a functional J-pouch, butt burn/itch may be in your near future.

The first output I had from my JPouch was like crapping razor blades and wiping with diesel fuel. You will want to have a sitz bath to help calm down your new bumm and the calmoseptine (ad on the right) is very helpful as you adjust.

Hi all thanks for your responses. My j-pouch is only created and not yet connected. I have the rod by the stoma and it will stay there for a couple of days  I can't change my bag until it's ready to come out. 

Yeah, I guess things are different between surgeons. I had an ostomy nurse come out for the first week and also changed my bag once in the hospital, before going home.  

Everything everyone else said. I’d add that protein is a great addition in your diet to help your body heal. Don’t be afraid to take advantage of the pain meds - that’s what they’re there for, for now. Good luck! 

Today they took out the rod, changed the bag with me, took out the catheter and the drain. I'm also no longer hooked up to the IV anymore. 

So I got home and I pooped out of my newly formed not yet connected J-Pouch. And I have absolutely no control. While I wiped I pooped out more. That is worse than the incontinence I had during my ulcerative colitis flare. Then I actually had pressure and this time I feel nothing. Will this pass? By the way it was actual stool and blood.

Probably want to check with your surgeon to be safe; however, yes, I believe this is normal.  Your newly created J-Pouch does not realize it is now the end of the line. You may have some leakage (gets better and stops), feel pressure but no output (I think what you are feeling is peristalsis - gets better) and maybe only mucus output. 

A sitz bath can help calm down the pressure, or a shower wand, or a regular bath. . .but if I remember correctly, I wasn't allowed to take a bath for quite a while.  And my abs were so sore, I doubt I could have gotten out of the tub if I tried one.

Hang in there! You're going to feel some new sensations, but it all gets better with time.

I told my surgeon and he said it's OK if it happens. I just wanted to make sure. 

I have that problem too. Every time I get up I feel pressure and the need to go. It’s just mucus however in the hospital it was blood and blood clots. It passes. So far I haven’t shizzed myself but it’s close sometimes lol

I've been pooping since this morning but the difference is this time I have control and I can hold it and go when I feel the need to go. My bag gets filled up too. So I guess I'm going number 2 and number 3. 

Congrats! Glad to hear you have control!  (#3 - lol)

I have another question. You know when we had a colon sometimes we pressed too hard and might have caused an anal fissure or something like that. I'm afraid now with the jpouch that I can pop a stitch. Can that happen? And how exactly does the surgeon attach the jpouch to the anus? I want to understand the physiology behind it. Whatever I Google it just says the surgeon attaches and I get pictures but I'm still not 100% sure on how he attaches it.  

The usual surgery attaches the J-pouch to the rectal cuff using a circular stapler. The less common approach removes the rectal cuff and the pouch is hand-sewn to the anal canal.

Thank you. He left my cuff