My daughter recently underwent j-pouch surgery for her severe ulcerative colitis. She's recovering well, but we are wondering about her future and what dietary restrictions she will have during and after recovery?
The j-pouch procedure is major surgery and will require a significant recovery time. During this recovery period, the colorectal surgeon may recommend a restricted diet. This is to prevent any problems, such as a bowel obstruction, while the bowel is still healing. Obstructions are more common after surgery on the intestines, and this is what the surgical staff and the patient will want to try to prevent.
As it is with ulcerative colitis, every person is different and one person will have different "good" and "bad" foods from another. There are, however, some basic guidelines that a person with a j-pouch can follow to help their pouch function better.
Directly After Surgery
Immediately following surgery the surgeon may provide instructions on how to eat. This may include instructions on a soft, low-residue diet. It is very important at this time to follow the doctor's advice, as it could help speed recovery and avoid possible complications. After the doc releases you to try new foods, do so one at a time, with caution.
Beverages
Water is an extremely important part of the diet after j-pouch surgery. After a colectomy, the body loses water easier and dehydration is a greater risk. A j-poucher needs to drink plenty of water each day, especially before, during, and after exercise, and during hot weather. Some fruit juices may cause diarrhea; carbonated beverages tend to cause gas; drinks with caffeine actually have a dehydrating effect. After surgery, a j-poucher may finally feel well enough to have some beverages that were not possible before the surgery, but she should always remember that moderation is important.
Snacking
After surgery it may be recommended that a j-poucher eat small, frequent meals to keep some food in the stomach all the time. Having some food in the stomach can also be helpful while taking certain medications, such as painkillers.
Perianal Skin
After a colectomy, there will be more bile juices moving through the body and out the rectum. This can result in some significantly uncomfortable burning sensations during and after defecation. It is important to take care of the perianal skin and to eat properly to avoid irritating it further. Foods that may cause burning stool include:
- Coconut
- Foods/drinks with citric acid (orange juice, flavored waters)
- Green or red peppers
- Hot-flavored foods
- Nuts
- Raisins
- Salsas
- Spicy foods
Foods That May Cause Diarrhea
A j-poucher is not going to have stools that are similar in consistency to a person who has not had a colectomy, but neither should they be loose or watery. Some foods that will cause diarrhea in one person will be just fine for someone else. The following foods may cause or contribute to diarrhea:
- Alcoholic drinks
- Apple juice (or copious amounts of any fruit juice)
- Baked beans
- Broccoli
- Cabbage
- Caffeinated beverages (coffee, tea, cola)
- Dairy
- Fatty foods
- Fried foods
- Hot peppers
- Prune juice (a natural laxative)
- Spicy foods
Foods That Help!
There are several foods that are generally easy to pass and may even help to create bulk and firm up stool. If a j-poucher is having a hard time with diarrhea, backing down her diet from new or untried foods and adding some of these foods may help to firm up the stool.
- Applesauce
- Bananas
- Hard-boiled eggs
- Hot breakfast cereals
- Mashed potatoes
- Oatmeal
- Peanut butter (creamy only)
- Plain pasta
- Toast (white bread or other types without seeds or nuts as tolerable)
- White rice
- Yogurt (with live cultures)
Caution Foods
After recovery and adjustment to the new “plumbing,” many j-pouchers can tolerate just about anything they want to eat…within reason. There are some foods that should always be eaten with caution, preferably in small amounts, with copious amounts of water, and never at the same time as any other caution foods. The following foods are difficult to pass and may contribute to a bowel obstruction:
- Corn
- Mushrooms
- Peanuts
- Popcorn
- Seeds
- Nuts
