What is normal with a pouch?

About 4–8 bowel movements a day, once or twice at night, with soft to formed stool. The aim is thicker stool and better sleep.

Everyday diet advice

• Have your main meal during the day and a light dinner three hours before bed to reduce night-time waking.
• Foods that thicken stool: rice, potato, banana, oats, bread, peanut butter, and soluble fibre such as psyllium.
• Foods that may increase frequency or irritation around the anus: very spicy food, fried food, a lot of coffee, fizzy drinks, sugar-alcohol sweeteners, and whole nuts and seeds.
• Drink enough fluids and add a little salt, especially in summer, because the body loses water and salts without the colon.
• A Mediterranean diet and eating fruit are linked with less pouch inflammation in observational studies May help
• If stools are frequent although the pouch is healthy, a temporary low FODMAP diet with a dietitian may help May help

Pouchitis

• The main treatment is antibiotics prescribed by your doctor; diet alone does not treat the inflammation Proven
• After a response to antibiotics, your doctor may prescribe a specific probiotic to prevent recurrence; not all products are the same Proven
• During a flare: small, easy-to-digest meals and oral rehydration solution, then a return to varied food as you improve.
• Iron, vitamin B12 and vitamin D are checked regularly because deficiency is common with a pouch Proven
• Avoid anti-inflammatory painkillers (such as ibuprofen) because they can irritate the pouch.