Question: Seeking Advice on Managing J Pouch Post-UC Surgery

My husband recently completed his surgeries for a J Pouch after dealing with Ulcerative Colitis (UC). We’ve heard that a good probiotic might reduce the risk of pouchitis. Is there a specific probiotic recommended by the society? He’s been using Metamucil for thickening the output, but his output is very active at night. We were told that Loperamide and Metamucil cannot be used together; is this true? Despite not eating past 7 PM and other methods, the output remains active at night. Any advice would be appreciated.

Response: Guidelines and Recommendations for J Pouch Management

Regarding your query on probiotics and pouchitis:

  1. Probiotics and Pouchitis: Currently, there is no scientific evidence to suggest that any particular probiotic can lessen the chances of pouchitis.
  2. Metamucil and Loperamide Usage: Metamucil and Loperamide can indeed be used in conjunction, but it is advisable to take them at different times. For example, Loperamide could be administered around 10 PM.
  3. Dosage Adjustment: Consider doubling the Metamucil dose, but this should be done under medical supervision.
  4. Dietary Consultation: Consulting a dietitian could provide tailored advice on managing dietary habits to better control the output, especially at night.

These recommendations aim to assist in managing the J Pouch effectively. However, it is crucial to consult with your husband’s healthcare provider for personalized advice and to ensure the safety and efficacy of any changes to his regimen.

Warm Regards,

Dr. Zane Cohen, M.D., F.R.C.S.(C)
Senior Colorectal Surgeon,
Sinai Health System


Leave a Reply

Your email address will not be published. Required fields are marked *