Congratulations, and welcome to life post-ulcerative colitis
! Your j-pouch
can be your best friend if you treat it right and take care of it at all times. The pouch is made of your own body, so it won't wear out or degrade, but it does need to be fed, watered, and taken to the doctor every so often. Here are some tips on how to keep your j-pouch in tip-top shape.
You already know that in the first few weeks of life with a j-pouch, you'll need a way to keep clean other than using garden-variety paper toilet tissue. Many people turn to wet washrags or even a bidet. But even after your perianal skin starts to feel better, and the burn is not so significant, it can still happen on occasion. Don't get rid of that A and D cream or the flushable wipes just yet. You will need them every so often, and you don't want to get caught in the middle of some horrible burning diarrhea without your trusted way of soothing the pain.
Do you need probiotics if you have a j-pouch? The answer is a resounding "maybe." You might think that if probiotics could be beneficial, you should take them (similar to Pascal's wager). However, you will need to know which kind of probiotics to take, how much to take, and how long you should take them. Probiotics -- especially those with patented formulas -- can be expensive and may not be covered by insurance or drug plans. Therefore, it's in your best interest to make sure that probiotics would be in your best interest and that you are taking the right formulation for you.
After the roller coaster of ulcerative colitis followed by the one-two punch of needing surgery and then actually undergoing surgery, you might be feeling like a new person as you recover. However, your diet is something that still needs close monitoring. A healthful diet filled with fruits and vegetables is recommended fort better health, but it's also important to understand the limits of your pouch. You may find certain foods give you diarrhea, while others are helpful for keeping your stools easy to pass. You might want to keep track of your diet in a notebook or on your smartphone or other device, to jog your memory about what foods you should avoid.
Don't forget -- you no longer have a colon. The colon's function is to absorb water. Therefore, you could get dehydrated very easily. Staying hydrated is partially common-sense -- if it's hot or you've been sweating profusely, increase your fluid intake. But good hydration is also more complicated than some simple advice to "drink more water." Sodium and electrolytes can also be lost during a bout of dehydration, and replacing them is an important part of rehydration. If you find yourself with a chronic problem with dehydration, talk to your doctor about what other steps you can take to avoid dehydration the future. Severe dehydration is a medical emergency, and if you experience symptoms such as a fever above 102 degrees Fahrenheit or severe pain, seek medical attention immediately.
5. Don't Throw Out Your Gastroenterologist's Number Just Yet
You might do very well with your j-pouch and never be sick a day again…or you might not. Your j-pouch might need to be monitored by endoscope on a regular basis for inflammation and dysplasia. There are no specific guidelines on how often your j-pouch should be checked, but once a year has been suggested as a possible interval.
Shuno Y, Hata K, Sunami E, et al. "Is surveillance endoscopy necessary after colectomy in ulcerative colitis?" ISRN Gastroenterol. 2011;2011:509251. 22 Aug 2013.