Life with a J-Pouch: What to Expect and How to Manage

For many people, a J-pouch brings a huge improvement in quality of life. But at first, it’s a major adjustment. Here’s what you can expect and how to handle it.

Some people go to the toilet as many as 12 times a day when they first start using their J-pouch. Staying busy can help decrease this number. Many people say that when they are out and about, they don’t have to rush off to the bathroom. It happens when they settle back in at home. But rest assured, your visits to the loo should decrease in time.

Some people with a new J-pouch get up more than three times a night to poop. It’s normal to go more often at first, but you may also be able to make adjustments so it doesn’t happen so much while you’re sleeping. Eat a light dinner, and try not to eat in the last 3-4 hours before bed. Try taking an anti-diarrheal before you hit the hay. Eat “binding” foods that help form solid stool, like bananas, rice, applesauce, toast, hot cereal, and soda crackers.

At first, your stool will be more liquid than solid. It may leak out easily – especially at night. You might also let some out when you thought you were just passing gas. Over time, your stool will become more solid and you should have fewer accidents. For now, you’ll need to be prepared. Keep a change of clothes on hand and consider protective products such as pads, underwear liners, and incontinence underwear.

First and foremost, eat! You need food to make things solid inside. You also need more salt as your body adjusts, so stock up on salty snacks. When you try foods you couldn’t tolerate before, introduce them one at a time to see how they affect your bowels. If you eat foods that might cause diarrhea, balance them with starches like potatoes or bread. Between 3 and 9 months after surgery, your body should be adjusting to the J-pouch, and you should be able to try all types of foods to see how they affect you.

Frequent watery stools leave your anus sensitive and irritated. Avoid hot and spicy foods. They will burn on the way in and on the way out. Nuts and seeds may be irritating, too.

When you’ve just had your colon removed, your body is figuring out how to absorb fluids. You’re losing a lot of water every time you go to the bathroom. Drink plenty of fluids. Water is best. But avoid fizzy drinks, caffeine, fruit juice, and drinking through a straw, which can make gas worse.

Liquid stools can inflame your rectum. Go easy on it. After a bowel movement, gently blot with soft, white, unscented toilet paper. You might also find it helpful to use a spray bottle or unscented, alcohol-free baby wipes. Make sure you get the whole area completely dry.

Warm baths soothe an irritated bum. But be sure to avoid scented products. After a bath, you can use ointment on your anus to create a barrier. This will keep stool off the delicate skin and prevent further irritation. Some people tuck a cotton ball near the opening of their anus to keep leaky stool off their skin.

For about 4-6 weeks after surgery, you’ll need to avoid strenuous activity and heavy lifting. But once your doctor gives you the green light, pretty much any physical activity you were comfortable doing before surgery is going to aid in the healing process. Get moving, and you’ll start to feel better!