J-Pouch, Fibre & Diarrhoea

Diarrhoea is one of the hardest words to spell in the English language – fact! I use a mnemonic to help me to remember how to spell it (two rakes and one hoe, if you are interested). I talk about it so bloody much, I need to be able to write it down.

Talking about poo becomes second nature in hospital – how much, how often, the consistency. Anyone with IBD will recognise the infamous Bristol Stool Chart – a source of much hilarity when my friends come and visit me in hospital. So much so I made one into a birthday card for my friend Jane (she loved it – thousands wouldn’t).

The Bristol Stool Chart

So referring to our illustrious guide, the BSC, the most solid poo you can really hope for with a j pouch is a Type 5. The halcyon days of Type 3 and 4 are well and truly behind you (sorry cant help the puns – we’re talking about poo). Most of the time however, my experience is of  Types 6 and 7. So how do you keep it more 5, less 7?

If you want to go down the medication route, loperamide is the drug to take. It is the active ingredient in over the counter anti-diarrhoea drugs like Imodium. I find it useful for a few days but it isn’t a long term solution because it makes me feel uncomfortably bloated.

Another route is diet. On leaving hospital, I was advised to eat a low fibre diet and to ‘eat like a teenager’ by my surgeon e.g. Crisps, white bread, chocolate. It’s an appealing idea for a few minutes but doesn’t seem great for long term health. So I did a bit of research and learnt more about fibre..

There are two types of fibre: soluble and insoluble. Soluble fibre is soluble in water and forms a gel like consistency in the gut. Insoluble fibre is not soluble in water, instead it absorbs water, drawing water out of the gut and increasing transit through the gut – not ideal for people with a pouch, although both types of fibre are good for a functioning colon.

I find that I can tolerate soluble fibre much better than insoluble. Insoluble fibre tends to give me diarrhoea and sometimes causes bleeding so I avoid it. I also avoid gluten.

Soluble fibre foods: fruits, vegetables, oats, barley, white rice, (well cooked) legumes Insoluble fibre foods: wheat, brown rice, rye, nuts, vegetable skins and pips

Sadly even with a soluble fibre diet I’m not consistently a Type 5 girl, more of a 6, but I am working on it, and avoiding gluten and insoluble fibre certainly helps.


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