J-pouch emptying

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Disneynut66
Veteran Member


Date Joined Apr 2009
Total Posts : 587
   Posted 4/14/2011 4:07 AM (GMT -6)   
Any suggestions on fully emptying the j-pouch? It takes me about 10 minutes to go and then sometimes it doesn't feel like I'm done. Is this normal and will this improve. I also have a problem distingushing whether it is gas or if I need to go--will that change?

Also, any suggestions for gas? I was a bit uncomfortable with gas yesterday. I think I remember people saying gas is worse the first few weeks, right?

Other than that, things are going really well. I think if I want to I could go back to work in a few weeks :-)

Dave D
Regular Member


Date Joined Aug 2005
Total Posts : 404
   Posted 4/14/2011 4:43 AM (GMT -6)   
During the years that I had my J-pouch(s) I discovered that when I sat down apparently there was a kink in my gut not allowing it to fully empty. My surgeon at the time said this was comion. So, before I wiped, I generally stood up to get the kink out.
Try it. Pretend it is some sort of salute.
Dave
Grandpa Dave is 72.
IBD since 1977
Perforation and resection 1993
Diagnosed as Ulcerative Colitis 1994
IBD since 1977
Received first J-Pouch 1997
Diagnosed as Chron's 2004
Redo, resection, and remove camera capsule 2005
Contracted Scleritis of the Eye 2008
Mild Stroke 2009.
Permenant Ileostomy 2011.

Four Grandkids

Older than dirt

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 4/14/2011 7:26 AM (GMT -6)   
It will get better but you need to understand that there is an adaption period. Your jpouch needs to learn how to function like a colon. Time will be your friend. Don't be surprised if you go and then 5 minutes later you realize you need to go again. This is normal. The gas is normal too and will get better. Measure improvement in WEEKS, not days. It's common for new pouchers to get frustrated at this point of recovery because things aren't perfect. Keep a food journal, see what foods have a longer transit time, skip bothersome foods for some time in the future, and continue to walk, walk, walk.

Sue

Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 4/14/2011 8:18 AM (GMT -6)   
I agree with Sue. There is a long period of adaptation and you do need to measure improvement in at least weeks if not months. As to your question of distinguishing gas from a BM. Some people can do this very well while others cannot. Dillon can most of the time but it still worries him so he usually heads to the bathroom when he "thinks" it is gas. He is most always right BUT not 100% of the time....thus the safety of the bathroom.
Mom to Dillon (age 19) who had three major UC flares over two years....Very sick. Colectomy Sept/09, J pouch built Jan/10 and take down Feb/10. Now out living life at University and doing great. NO MEDS

Scrap Girl
Veteran Member


Date Joined Jan 2007
Total Posts : 653
   Posted 4/14/2011 8:48 AM (GMT -6)   
Glad to hear you are doing well and almost ready to return to work already. I found that if I want to hurry things along I can stand up, bend at the waist like I'm picking something up. A few seconds in that position really speeds things up for me and I can empty right then. I can usually be done with everything, including my bidet rinse, in about two minutes. I think it's a gravity thing. I'm sure you'll learn a little trick in time too. Some people cough. Everyone is different. I think this is why they don't send you home with a lot of information from the hospital because everyone's body responds differently. I've only called my surgeon's office once since my surgery because I feel like it's really hard to explain these kinds of things to anyone who hasn't gone through it personally.
 
Have you ever looked at Dennis' j-pouch videos on you tube? They are pretty helpful. I've only seen a few but he has a whole series of them. Just watched his one last week on j-pouch spasms. He did a great job of explaining the feelings I get from time to time. He calls them spasms but I don't think a name has been coined for these yet. Mine are never painful but they last about four seconds and can be annoying. But people talk about pressure, urgency, spasms, gas and it's hard to figure out if we are all talking about the same feeling or different things? This is kind of the confusing part. Whatever they are they have gotten better over time and I think they will continue to improve. Also, I have found that time of the month changes things a bit for me - more watery stools and spasms. It really is "a curse."
 
The gas should impove too. I drink 3-4 soft drinks a day and I rarely ever feel gas pains anymore. Sometimes I will hear the gas rumbling around but I can hit the restroom and it normally comes right out. Once in a blue moon I will feel gas around my shoulder area. Releasing gas is also part of the learning process. Some people have to do it on the toilet while others can do it sitting or lying down and some even standing up. But it can take a while to figure out how to do it without anything besides gas coming out. Don't know if you've mastered that yet :-)

Disneynut66
Veteran Member


Date Joined Apr 2009
Total Posts : 587
   Posted 4/14/2011 9:17 AM (GMT -6)   
Wow, great tips! I tried the standing thing that Dave and Scrap Girl talked about and it worked like a charm. Good to know that it's ok that after I go I have to go again in 5 minutes.

I will try to be patient and think in terms of weeks and months not days. I am really happy that I am doing so well.

I just went to the community swimming pool to watch my old special needs kids swim. To me that's amazing that I have that much energy and I am feeling good enough to join them.

I will look up Dennis' videos. I am sure they will be helpful. Everyone asks how I am doing...my standard response is "I feel great, but am adapting to my new plumbing system."

You all are the best. I don't know what I would do without you all to help me in this process.
Diagnosed 2006. 1st step of 2 step j-pouch 1/3/11. 2nd step April 4, 2011. So done with this disease.

ByeByeUC
Veteran Member


Date Joined Feb 2011
Total Posts : 4544
   Posted 4/14/2011 10:13 AM (GMT -6)   
Another thing to be aware of is a stricture. Sometimes it's hard for me to empty all the way and it's because I have an anal stricture that needs to be dialated in my surgeons office. Thank goodness it's getting better now. When you go for your follow up visit I believe it's pretty routine for you to be checked for that.
DX UC - in 2005 when I was 37
Tried every drug-even Remicade-nothing worked
Step 1: J-pouch surgery (Laparoscopic restorative proctocolectomy w/ temporary diverting loop ileostomy)6-25-10
Step 2: Take down surgery (Ileostomy reversal)10/8/10
Very pleased with my results

Disneynut66
Veteran Member


Date Joined Apr 2009
Total Posts : 587
   Posted 4/14/2011 10:22 AM (GMT -6)   
So, how would I know if I had a stricture? If I am not having any problems, they are letting me do the follow-up over the phone because I live so far away. I check in every 2 weeks, then talk with the doctor at 6 weeks. My output looks great...I wasn't prepared for it to look like poop again after my ostomy. It is formed most of the time and its a bit thin, but getting thicker in size every day!

Also, Dave, is a kink dangerous? Is that something that I would have to worry about?
Diagnosed 2006. 1st step of 2 step j-pouch 1/3/11. 2nd step April 4, 2011. So done with this disease.

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 4/14/2011 10:40 AM (GMT -6)   
I would rule out stricture and kinks at this point. You are so new in recovery that you need to give the adaption time. It's sometimes best if you don't hear of these other problems. I really believe your current problems are normal recovery. However, should you experience new pain then by all means go see your surgeon.

Sue

ByeByeUC
Veteran Member


Date Joined Feb 2011
Total Posts : 4544
   Posted 4/14/2011 11:07 AM (GMT -6)   
I didn't know I had a stricture until my follow up visit. I thought what I was experiencing was normal. I basically just had a hard time emptying. I never had any pain or anything like that.

It really sounds like you are doing fine though.
DX UC - in 2005 when I was 37
Tried every drug-even Remicade-nothing worked
Step 1: J-pouch surgery (Laparoscopic restorative proctocolectomy w/ temporary diverting loop ileostomy)6-25-10
Step 2: Take down surgery (Ileostomy reversal)10/8/10
Very pleased with my results

betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 4/14/2011 7:36 PM (GMT -6)   
@Scrap Girl
Are you the one with the really cool sounding rinsing bidet? If so i was wondering if you could tell me more about it, like what brand it is and is it part of the toilet or an extra thing you sit on the toilet and the like.
-diagnosed with UC Dec 2006 at 22
-allergic or intolerant to all 5ASAs, sulfa and 6-mp
-emergency transverse colostomy on 9/13/10 from perforated colon
-J-pouch surgery step 1 of 2 3/21/11

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 4/14/2011 8:02 PM (GMT -6)   
I'm not scrap girl, but I got a biffy bidet attachment which helped a lot before surgery when I was going to the bathroom a lot. It's about $100, and not that hard to attach to the toilet. I used so much less toilet paper with it, and had a lot less irritation too. http://www.biffy.com/cart/index.php/latest/biffy-universal-bidet.html

Now that I have an ileo, it's not that helpful, although still good for a heavy period.

It does take a bit of getting used to in the winter, because it's cold water.... I was OK with it, but they do sell something to heat the water too.

There are other brands around too.
48 years old, female.
2004 dx indeterminate colitis. Many drugs, minimal success.
2010-11 Official dx Crohn's colitis. Crazy complications -- cutaneous Crohn's, Erythema Nodosum, marginal keratitis, high fevers. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Scrap Girl
Veteran Member


Date Joined Jan 2007
Total Posts : 653
   Posted 4/14/2011 9:23 PM (GMT -6)   
Betsaronie, I bought the Coco 6035R and it's just a seat that you install on the toilet - very easy to do. First you take off the regular toilet seat. Mine came with a remote but I rarely use it because on the side of the seat there's a button you can push too. I love the heated seat and the warm water. It also has a dryer, which I never use anymore. All it takes is about 20-30 seconds of rinsing, a quick wipe and I'm good to go. If you want warm water you need an outlet nearby. I had one installed by an electrician. I think you can use an extension cord - as long as it is the right kind - if you don't want to pay to have an outlet installed. But I never have to use creams anymore. Over spring break I went out of town to visit my parents but I really missed my Coco. Can't say enough good things about bidet seats.
First step of j-pouch - April 1, 2010
Second Step - 9/21/10
Third Step - 12/14/10

betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 4/20/2011 4:54 PM (GMT -6)   
thanks for the info! I've heard of those coco's before, like the gold standard for j-pouchers! I'll look up the biffy one too. :)
-diagnosed with UC Dec 2006 at 22
-allergic or intolerant to all 5ASAs, sulfa and 6-mp
-emergency transverse colostomy on 9/13/10 from perforated colon
-J-pouch surgery step 1 of 2 3/21/11

ducridr
Regular Member


Date Joined Apr 2008
Total Posts : 139
   Posted 4/22/2011 9:34 AM (GMT -6)   
I remember post surgery #3 when I was adapting to my new plumbing I would lean forward and back and also side to side to make sure that I got everything out in one trip while my pouch was growing. 1 yr later and I sometimes lean forward and back - but I think that's just a habit now. Just be aware when using automatic flush toilets...when you stand up or lean sometimes they think you are done and flush. I'm also short so this may be a bigger issue for me than for taller people.
Ducridr - 37 - female

Diagnosed w/ severe pancolitis 11/20/2007
J-Pouch surgery #1 of 3 on 8/21/2009!!!
Surgery #2 - 1/4/2010
Surgery #3 - 3/23/2010

Disneynut66
Veteran Member


Date Joined Apr 2009
Total Posts : 587
   Posted 4/22/2011 12:16 PM (GMT -6)   
It is getting easier to empty. I am not in the bathroom for 15 minutes anymore. More like 5-7 and then I feel like it's empty.

Question regarding butt burn for all you old timers...does it last forever or does your body eventually get used to it? I can't complain, it's not too bad, but I was wondering if I have to use the cream forever.
Diagnosed 2006. 1st step of 2 step j-pouch 1/3/11. 2nd step April 4, 2011. So done with this disease.
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