Diet After J-Pouch Surgery

Q. What foods are allowed after j-pouch surgery?

A. 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 while the bowel is still healing. Blockages are more common after surgery on the intestines, and this is what the surgical staff and the patient will want to prevent through a proper diet.

As with all intestinal conditions, every person is different and will have different “good” and “bad” foods. 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 after surgery the surgeon may provide instructions on how to eat, possibly 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 with caution.

Beverages

An extremely important part of a j-pouchers diet is water. After a colectomy, the body loses water easier making dehydration 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. Eating can also be helpful when taking medications such as pain killers.

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 during and after defecation (sometimes known to j-pouchers as “Taco Butt”). It is important to take care of this 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 it 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 slow it down.

• 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