Wet Farts

When this happens to me more than occasionally it means I need to get treated for pouchitis.

I am with Scott. Other than the occasional thing, excessive gas usually means pouchitis or bacterial overgrowth. I make sure to empty as much as possible before going to bed. Imodium helps improve rectal sphincter tone (it naturally relaxes during sleep, specifically to release gas), so if you aren't taking it, it is worth a try. Of course, it might mean waking up to use the toilet instead of messing your pants. Pick your poison, I suppose.

Jan

I'm on Augmentin now for a sinus infection and will be for 15 days. This should be interesting, and of course wonderful if I could only wake up without a mess to clean up.

I'm also using Lomotil and seriously thinking of trying immodium - personally, I don't think that either one of them help me, but it's certainly worth a try. I do eat a lot of sweets (I know they're bad) but I'm a junk food junkie and can't help it, however, I'm going to try to stay away from the bad stuff for awhile and hope that it's not pouchitis. Actually, just wondering, if it is pouchitis, why don't I have problems during the day?

Thanks so much for the advice, it's always appreciated!

Mema 1,

Even when my pouchitis is pretty bad, it doesn't affect me all that horribly during the day. My pouch really starts up after 4:00 in the afternoon and will be bad all throughout the evening and night. I suspect you will be sleeping better this evening and might even sleep 8 hours without waking :-) Laying off the sweets will help you quite a bit with the gas and potential pouchitis.

If it was pouchitis, the augmentin would very likely take care of it. If you must have sweets, try to restrict them to early in the day, not near bedtime (inviting trouble!).

Jan

I agree I love sweets and eating them later in the day is just asking for trouble. I'm a kit kat fiend and every time I would have one at night I would wake up with a mess in my underwear. I tried multiple times and never failed everytime. Cut off your eating earlier and make sure you last meal isn't some junk food. I would make sure your dinner includes some foods that are binding so you don't have such issues.

Thank you all for your wonderful advice. If it were pouchitis, wouldn't I have any other symptoms? I realize that I have been eating dark chocolate every night before bed and wondering if that's not the culprit. Hopefully, taking the Augmentin will kill two birds with one stone and I'll try to keep the sweets to a minimum, if that's possible or eat them earlier in the day.

I don't know what it's like having a "normal" pouch - and I've had one since 2001 - if I don't have one problem, there's always another, oh, well.

Just curious, Jan, do you feel that Immodium is better then Lomotil? The best part of Lomotil is that I can get so many with a script and keep the cost low...since Immodium is not a script, it's so much more expensive, but the luxury of using it and working would be worth it since I'm not sure that the Lomotil does any thing at all except make me sleepy.

One other question, if it is a bacterial overgrowth, would the Augmentin take care of it in 15 days - that's how many the doctor has ordered for me.

Thanks again - you're all so great - it's such a pleasure to know that I can ask anything that I need to on this site and get such helpful answers...only problem is that it makes me so sad to read about all the major problems that some people here have - makes me feel lucky to just have a little poop in my pants.

If you see drastic improvement with augentin, then you could have had pouchitis or bacterial overgrowth. A couple of weeks may not be enough, or you may need to follow up with probiotics.

Lomotil and Imodium are pretty similar in their action, but for whatever reason, Imodium increases rectal tone and lomotil does not.

I have had an Imodium (generic loperamide) prescription ever since my surgery in 1995. While it is OTC, many plans cover it as a prescription, if your doctor puts in an exception for it (I needed high dose, long term therapy). Since it is is not a controlled substance, your doctor might be willing to check that box for an exception.

Jan

Jan, thanks for all the information. I made it through the night with just a tiny bit of leakage when I woke up - problem is now, I'm on the constipated side and rally have to push to get it out, now I'm thinking that maybe I shouldn't be using any Lomotil while taking the Augmentin. I can't remember in the past if this ever happened before - I'm so used to take the necessary drugs for me to be able to leave the house and feel comfortable and not have to go running to find a bathroom and now I don't know what to do!! As far as the probiotics go, I take them already - actually, I take 2 PB8's in the morning and 1 Culturelle at night before bed. I know to leave enough time between the antibiotic and the probiotic but wondering if I should stop everything until I'm off the Augmentin and continue on with the probiotics afterwards - any suggestions on that?

Just checked my script for Lomotil and it's Diphen/Atrop - is that the generic for Lomotil or Immodium?

That's Lomotil.

I usually take my 2nd dose of Lomitol and Bentyl just before I go to bed. I have only been on these meds for 5 weeks (3 months post take-down) and they have reduced my spasms and diarrhea tremendously.

I have discovered that my pouch does not like dairy, but I love dairy and refuse to stop eating foods with dairy, so the meds allow me to continue my bad habits without severe consequences.

During my first year on Augementin (while it worked well still), I could not take bowel slowers with it. That would have been way too much at one time. I would suggest you let the antibiotics do their thing and take a break from the bowel slowers. You can always add them back in if you feel you need it.

I'd definitely stop or reduce the Lomotil or Immodium while on Augmentin if they are making things too thick. Remember that these are only to control symptoms, so adjust them as necessary to keep things about right. There's no reason to stop the probiotics, though, and plenty of reasons to keep taking them while on antibiotics, even though they won't be as effective.

Pouchitis can creep up on you very slowly. Sometimes the first sign is deterioration of control at night.

I'm wondering how effective the probiotics that I'm taking are if I do have pouchitis or a bacterial overgrowth for that matter. I've been on the same ones for MANY years, maybe it's time for a change - any suggestions on which ones I should be trying out or should I stay on the same ones. I guess everyone gets used to what they have to live with every day, but have to tell you, I don't remember when I've felt better. I was on Augmentin at least two years ago, and I think I did well on it then, but I really do hate to be on antibiotics, however, I feel like I'm on the best vacation in the world right now!!!

I just stay on Cipro all the time now. I suspect the folks who've had C dif think I'm crazy.

Probiotics differ in the number and selection of organisms per dose. One organism = 1 CFU (Colony Forming Unit). I'd suggest knowing how products compare when choosing a substitute.

I've been happy with VSL #3 DS at the max dose (4 packets per day). That's a lot of bugs.

Thanks, Scott. I'm just really curious why you stay on Cipro if you use VSL. Aren't probiotics supposed to help so that there is no need for an antibiotic?

Every time I've tried to eliminate or reduce the Cipro I've become symptomatic. I think the probiotics are probably still useful, but not useful enough at this point to eliminate the need for antibiotic treatment.