What Foods Are OK to Eat After J-Pouch Surgery?

Toast with peanut butter on it

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The j-pouch procedure (for which the technical name is ileal pouch anal anastomosis, or IPAA) is major surgery and will require a significant recovery time. The surgery is typically done in one, two, or three steps, with the two-step process being most common. During the recovery period after the creation of the j-pouch, a colorectal surgeon may recommend a restricted diet. This diet is necessary to prevent any problems, such as a bowel obstruction, while the bowel is still healing. Obstructions are more common in the period 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 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. Most people go on to enjoy a much higher quality of life than they had before their j-pouch surgery, even if the diet is, at times, a bit restricted.

Diet Directly After Surgery

Immediately following surgery the surgeon may provide details 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 (which is one part of j-pouch surgery), the body loses water more easily 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 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.

Foods to Avoid

After a colectomy, there will be more bile juices moving through the body and out of the rectum. This extra bile 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 the skin further.

Foods that may cause burning stool include:

  • Coconut
  • Foods/drinks with citric acid (such as orange juice and tomato products)
  • Green or red peppers
  • Nuts
  • Raisins
  • Salsas
  • Spicy foods

Foods That May Cause Diarrhea

A j-poucher's stools are not similar in consistency to a person who has not had a colectomy, but neither should they be loose or watery. Some foods that cause diarrhea in one person will be just fine for someone else. The following foods may cause or contribute to diarrhea in people who have had j-pouch surgery:

  • 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

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 have the potential to contribute to the development of a bowel obstruction:

  • Corn
  • Mushrooms
  • Peanuts
  • Popcorn
  • Seeds
  • Nuts

Foods That Help

There are several foods that are generally easy to digest and may even help to create bulk and firm up stool. If a j-poucher is having a hard time with diarrhea or loose stool, backing down from new or untried foods and adding some of these foods back into the diet 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)
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Article Sources
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