Diet Challenges After J-Pouch Surgery

Hi all,

I had a subtotal colectomy in Feb 2011 due to UC and have recently had reversal surgery to have the j-pouch formed. Im now 7 weeks post op, had a problem with a couple of infections (a water infection caused by the catheter and one at the bottom of the incision) but these havent been too troublesome, although I think the water infection has reoccured. My main problem has been consistency of the output. Im finding it extremely hard to keep the output thick enough. Most days it seems that anything I drink goes straight through me into the bag, in fact a couple of weeks ago I became very ill and the doctor said that my kidneys were drying up and not functioning properly as I was so dehydrated (Ive also lost about 20lbs). Ive been taking advise about what to eat and am taking immodium but I was hoping that you good people on here could let me know if theres any specific food which seems to work better than anything else for you. Any input would be very much appreciated, many thanks guys  

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I had a temporary ileostomy for 9 months then J pouch in a 2 step process.  I find that eating foods such as bananas, rice, applesauce and white bread / toast (nicknamed BRAT diet) are best for stool thickening.  Nexts are pasta, dairy products, tapioca, potato, and peanut butter.  I find that just as or more important than what I do eat is what I don't eat.  Even if you eat stool thickening foods, eating stool thinning foods will quickly more than offset the benefit of stool thickening foods.  The biggest stool thinning foods for me seem to be sugar, pop, spicy foods, and fruit.  Obviously everyone's body is different and you may have other issues going on it but the above examples are generally true for the average person.



Also keep some optimism because I am told that over time (months and years not weeks) the end of the small intestine begins to realize it is the end of the line and eventually absorbs more water and acts more like the colon thickening stool more.  I hope this helps and also know that about 93% of all UC Patients that get a J Pouch still have them 10 years later - pretty good odds.  Many of the people with no problems move on with their lives so they aren't posting their success online.

It usually does get a bit better but can be a real struggle for some of us. I have a permanent ileostomy (2009) after prolonged hospitalization with a lot of complications. I've been classified as having "short gut syndrome" where by body never really did adapt very much so that I struggle with high thin output. Over time I have learned what works for my body, as well as food to avoid. I found that it is a process of frequent adjustments. I can say that I am now able to eat more frequently and have a wider choice than in the first year post-op.



Here's the quick list, going from most to least effective or important .





Meds: tincture of opium, lomotil, loperamide; also I use a cholesterol medicine powder (cholesitpol) to thicken my output 1-3 times a day depending on how bad things are.It's a pain because you can't take too close to other meds or it will absorb them, but I do much better when I have it at least once a day.



Foods to eat to slow down/thicken output. Potatoes including sweet, peanut butter, marshmallows (which I eat pre:appliance change so I can get a good seal without constant output).



Foods to avoid: pineapple coconut tomatoes. One of biggest things for me was the maltilol and other artificial sweeteners in 'sugar-free' and regular processed foods is a laxative but added to many products to sweeten and stabilize. I have to look at labels for a lot of things so I can adequately avoid foods that cause increased output. I still am unable to eat salads and greens or McDonalds fries- my short gut becomes a rapid transit system,as described above. The other things is many juices end up pulling water into your GI tract because they are so concentrated. I have to dilute any juice to avoid increasing my output .





the best advice I can give you is to experiment and learn how you body responds now and over time. Luckily there are several remade versions of mashed potatoes in most grocery

Y stores. Good luck. Karen

Thank you so much for your replies Pentat and Karen, I've been giving a few of those a go but not all so think Id better get to the shop with your lists!

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Ive got an appointment with a stoma nurse next week so I'll discuss medication options with them then. I was told that things should improve after take down as more of my intestine will be used for digestion then and what youve said about things taking time gives me hope! I really appreciate your input, thanks again.