My husband has just finished the last of the surgeries to have now a J Pouch (He had UC). I have been reading that a good probiotic will lessen the chances of pouchitis. Is there one that the society recommends? My husband used Metamucil to have his out put stay thick which is great BUT his output is VERY active at night and he has been told he cannot use Loperamide and Metamucil together. First is that correct? He does not eat past 7 at night and has used other tricks to try and slow it but nothing is working. Any suggestions?


First, there is no evidence that any probiotic will lesson pouchitis.

With respect to Metamucil and loperamide, yes they can be used together but should be used at different times.
Loperamide could be used around 10 at night.

Could also double the dose of Metamucil.
Agree with seeing a dietician.

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

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