Time-release medications tend to be a poor choice for J-pouchers. Some of them probably work okay for us, but it’s not generally a good idea to count on them.

Oh do not worry; even though the pills come out fully formed, the medications still get absorbed. I have read about a lot of pills that have the side effect of coming out fully formed but they still get absorbed okay. It may be less absorbed compared to colon folks since we have lots of diarrhea but I think you are okay

I doubt that an ‘intact’ enteric coated pill gets absorbed ‘okay’. Absorption rates were tested on people who have colons. You could ask for a regular coated, uncoated version, as older versions of many drugs were not enteric coated, or time released.

Enteric coated medication (and birth control pills) are not properly absorbed. You need to switch meds. I'm surprised your doctor didn't think of this!

The transit time is around 4 hours to evacuation with a J pouch  and timed release is designed for way longer than that as mentioned by Elif. Simply put all of the medication will not release in 4 hours. This is or should be common sense based on having a much shorter digestive tract. You will never get the intended benefit for any timed release meds unless they are specially designed for J pouches. And I haven't heard of any such thing. All my doctors told me do not take them as you are not getting the full benefit of the medication, or perhaps any at all, if it is a delayed time release of more than 4 hours.

Echo the responses above. I've always been told that time released medications are not a good choice for people who have had a colectomy, as the medication may pass through your system before it can be fully absorbed.  So while it's true you will get some of the medication, you invariably risk not getting the full therapeutic dosage. Not all doctors seem to be aware of this either, or else they prescribe these medications so frequently to their patients, they overlook it for patients who have had a colectomy. So it's important to always ask for non-time released versions, or alternative medications if necessary.

@Spooky posted:

Echo the responses above. I've always been told that time released medications are not a good choice for people who have had a colectomy, as the medication may pass through your system before it can be fully absorbed.  So while it's true you will get some of the medication, you invariably risk not getting the full therapeutic dosage. Not all doctors seem to be aware of this either, or else they prescribe these medications so frequently to their patients, they overlook it for patients who have had a colectomy. So it's important to always ask for non-time released versions, or alternative medications if necessary.

Wow, all of that makes sense! I wish doctors including gastros would advertise that more. Hopefully one day every doctor including Gastros will realize that too.

Since I go 13-20X a day, I definitely need to keep that in mind for sure LOL

Thank-you very much for sharing that everybody! I bookmarked this page that way I can always refer back to it. I like to advertise a lot of things that a lot of people do not know about colectomy people; now I have another thing to advertise!

Thank-you so much everybody

@Tori R2 posted:

I have a J pouch reconstruction, and deal with pouchitis.

Basically, I don’t have a large intestine, and therefore, like many of you, I have noticed that food goes through me pretty quickly.

Lately I’ve noticed that a time release medication I take (for diabetes, a different discussion), is coming through my system ‘intact.’ So, I am obviously not getting the benefit of these meds.  Has this happened to you?

I apologize for giving you the wrong advice regarding absorption, I never knew about absorption being reduced in us when it comes to time release medications. I wish doctors were more educated about things like that and in letting us know. We definitely do not need to be taking time release or extended release medications. I go 13-20x a day so I would extremely be in trouble taking that lol.

An enteric coating is a barrier that controls the location of oral medication in the digestive system where it is absorbed. The word “enteric” indicates small intestine; therefore enteric coatings prevent release of medication before it reaches the small intestine.

An enteric coating, also known as gastro-resistant coating is a barrier applied to oral medication that controls the location in the digestive tract where it is absorbed. The term “enteric” refers to the small intestine; therefore, enteric coatings resist breakdown of medication before it reaches the small intestine.

**Enteric-coated tablets dissolve in the small intestine**

Tori R2 says " is coming through my system ‘intact.’" If the pill is "intact", obviously the coating hasn't dissolved.

"therefore, enteric coatings resist breakdown of medication before it reaches the small intestine"

This merely says the coating will pass the stomach, but it does not say it will dissolve (fully or partially) in the small intestine. Obviously, as in the case of Tori R2, the coating did not dissolve.

I once saw a whole coated mesalamine pill pass through my system intact during a severe UC flare, which was supposed to target the colon.  So, not all coated drugs have the same delivery mechanism and are designed to dissolve at the same area in the digestive tract.