5. Emptying Problems

The patient is able to state measures to alleviate emptying problems.

Looseness and frequency of stool is not uncommon during the early months following pelvic pouch surgery. It generally takes at least six months for the pouch to "adapt" - begin functioning and acting like a pouch or reservoir. It is extremely important to keep the skin around the anus clean, dry and intact.

Suggestions

Allowing time for movements is an important factor in successfully emptying of the pouch. The rectum normally contracts to squeeze stool out like you would squeeze toothpaste from a tube. This is why going to the bathroom is normally fairly quick and easy. A pelvic pouch, however, has to empty using gravity and this can take time. If individuals with pouches spend only a few seconds on the toilet they may only empty stool from the bottom quarter of their pouch. Then, 10 minutes later stool in the upper part of the pouch falls into the lower part and there is another trip to the toilet. It is suggested that a patient sit and rest. Allowing the pouch to empty more completely will decrease the number of toilet visits.

It has been suggested that Imodium™ or Lomotil™ is helpful in slowing the bowel but Imodium may also create additional problems. By thickening the stool too much and by reducing peristalsis even further, it may make emptying the pouch more difficult and make matters worse. Sometimes a semi-liquid stool is an advantage.

Individuals have also reported that shifting on the toilet, standing and sitting allows for a better, more complete evacuation.

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