Eating

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Following pelvic pouch surgery, there will be a period of adaptation that may take up to one year. Over time, pouch storage capacity will increase and the number of bowel movements per day will decrease. Stool consistency will thicken over time. Diet and medication can help to improve pouch function. It will be important to resume normal, healthy dietary patterns over the course of time.

The following includes general dietary tips as well as a list of foods that may contribute to stool looseness and frequency experienced during the period of adaptation.

  • Try to develop regular eating patterns which allow your pouch to adapt and function in an appropriate manner.

  • Smaller meals may be better tolerated, but it is important to eat more often to ensure adequate intake.

  • Eat you meals in a relaxed environment. Take your time, chew your foods slowly and thoroughly.

  • Drink plenty of fluids each day (i.e. more than 8 cups of liquid per day).

  • Add "potential" problem foods to your diet gradually to see how your body responds.

  • When a food causes a problem, it should be temporarily eliminated, and then tried again at a later date.

  • Eat a balanced diet. Incorporate all food groups.

Remember to include foods and fluids high in potassium and salt during periods of stool looseness and frequency.

Foods or Beverages that May Cause Stool to Become Looser or Increase Pouch Output

  • apple juice
  • highly spiced foods
  • raw fruit & vegetables
  • prune juice
  • red wine
  • broccoli
  • baked beans
  • beer
  • chocolate
  • green beans
  • milk
  • beverages containing caffeine
  • spinach
  • cabbage

 

Foods that Thicken Stool or Decrease Pouch Output

  • white rice
  • buttermilk
  • tapioca pudding
  • pasta
  • cheese
  • potatoes
  • bread
  • marshmallows
  • creamy peanut butter
  • bananas
  • toast

  • applesauce
  • yogurt

 

Foods that May Contribute to Anal Irritation

  • certain raw fruits & vegetables (oranges, apples, coleslaw, celery and corn)
  • coconut
  • citrus juices
  • popcorn
  • dried fruits (raisins, figs)
  • chinese/oriental vegetables
  • food with seeds
  • nuts
  • spicy foods

 

Foods that Cause Gas

  • cabbage family vegetables: broccoli, brussels sprouts, cauliflower, cabbages
  • melons (watermelon, cantaloupe, honeydew)
  • Asian vegetables such as bok choy
  • spicy foods
  • asparagus
  • old or mold cheeses such as Brie, Roquefort, Stilton, cheddars
  • sweet potatoes
  • beer and red wine
  • turkey
  • carbonated beverages (pops, mineral water)
  • legumes (lentils, peas, beans)
  • onions and garlic

 

While the above foods are common sources of gas, individuals may have their own experiences with foods that may cause gas. Some people report gas with greasy/high fat foods and chocolate.

Keep in mind that everyone's response following pelvic pouch surgery is very different. What may upset or create problems for one individual may be well tolerated by another. Try all foods and only avoid those that repeatedly cause unacceptable problems. Tolerance may change with time, so periodically retry small quantities of any foods avoided.

Gas and Bloating

Gas and bloating are a common complaint with pelvic pouch patients. While dietary choices may be a contributing factor, it is usually due to an overgrowth of bacteria in the pouch. Dietary changes should be considered first by avoiding foods that cause gas such as cabbage family vegetables, onions, sweet potatoes, turkey, asparagus, dried beans, beer, etc.

Frustratingly, sometimes the foods that cause gas are also the foods (high fibre foods) that may be helping to thicken stool. If this is the case, consult a dietitian to help review food choices that will lessen symptoms of gas and bloating, but will also allow you to maintain a thicker consistency for your stools. Some people find that over-the-counter preparations like Beano may be helpful in decreasing the amount of gas experienced with high fibre foods. Others have reported that eating yogurt (such as the Balkan yogurts) may decrease gas.

If dietary changes are not effective, antibiotics may be helpful to lessen gas and bloating. However, often the symptoms will return once the antibiotics have been completed.

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