oozier wrote: In fact I've found laxatives better for improving consistency and predictability.
Thanks Jan - when you have a moment I'd be interested in hearing about this. I'm doing 4-6 Imodium/day on the theory it slows the bowel, but would be interested to know what you meant about laxatives vis a vis consistency and predictability.
Hi Jim and fellow reversalists.
I'll preface my response by saying that I'm on long term pain medication so my 'normal' pre-dx was severe constipation treated with dulcolax and sennekot. Post-reversal, I only had loose stools for the first few days. These were quickly replaced by firm stools, but I still had frequency, urgency, clustering, and tenesmus. Despite knowing about my pre-dx constipation, at my 4 week check-up my surgeon recommended I use loperamide to address the frequency and clustering. I only took one loperamide once...on the plane trip home after reversal...and I paid the price. Clustering is bad enough with loose stools but with hard stools it's the pits. I was advised not to take any laxatives until my bowel settled into its 'new' routine, and to try to manage things via diet. So, I kept a food/BM diary for several months, but could never really find any significant patterns. Sure, if I kept to my 'safe' foods things were better, but at best all I could say was that I 'might' have a few BM's after breakfast, followed by a break, then things started again late afternoon and I generally had 8 to 10 BM's in the evening.
As time went on the frequency and clustering did reduce however I noticed that I was getting more and more constipated (making the clustering more painful) and the tenesmus was increasing. The constipation continued despite having rolled oats for breakfast, a high fibre lunch and dinner, heaps of water, and walking/swimming three times a day. About this time I read Tammylayne's post about her surgeon suggesting clustering might be more to do with constipation. So I started experimenting with laxatives and hey presto, the clustering and tenesmus dramatically decreased. Then I read about others using enemas or prune juice to have a 'clean out' in order to provide a safe window in which to have a life, so I continued to experiment with laxatives to get some predictability back into my life.
Now, it's certainly not perfect, but at 9 months' post-reversal, if I take my laxatives about 11am and stick to my 'safe' foods, I can be fairly sure that I'll have 2 or 3 loose BM's in the late evening that completely evacuate my bowel. This gives me some certainty that I have all day to do the things I need to, without worrying about multiple trips to the loo. However, this regime may only work if you're like me and prone to constipation.
I tend to agree that often the advice given post-reversal is a 'one size fits all' kind of response. I think this is because there really hasn't been enough research done on us reversalists. The main focus has been on avoiding a permanent colostomy, and research is only now focusing on the trade-off that sphincter-sparing surgery brings. Perhaps we should start to develop our own data set....
Hang in there Jim. I know only too well how frustrating this journey is, but time really does bring some improvement. So much so that my partner and I have taken the plunge
and booked ourselves on a cruise from Oz that calls into NYC in July. My first ever time to NY so I expect you to have those bowels under control so that you can show us around