People with Fecal Incontinence: Psyllium Fiber?

I lost my entire colon due to cancer surgery, which means my feces is always runny (I have no colon to remove the liquid), difficult to control and frequent (8-9) times a day - including overnight events.

Per Mayo Clinic, I was directed to make a barely drinkable slurry of Metamucil (psyllium fiber) and drink it. The psyllium fibers absorbs excess water, helps make the stool more semi-solid and also easier to control. I do a heaping teaspoon in 2 ounces of water 4 times a day. 2 hours after breakfast, 1 hour after lunch, 2 hours after evening meal and in the middle of the night when I wake up for a bathroom run. The delays are to enable absorption of medications which this can impact. If you mix it with too little water, you can even eat it with a spoon much like applesauce although I don't recommend that.

So the normal use of MM is to drink it with lots of water to loosen stools, but it also tightens stools if used in a larger quantity with minimal water.

Some practical notes - some of which would apply to other readers.

1) amount and frequency will vary so some experimentation with quantity and frequency is necessary and can take some time to figure out.

2) Some of the non MM fiber supplements that have psyllium fiber also have granulated sugar which can aggravate diarrhea, I found these unhelpful. There are also some with artificial sweeteners such as aspartame to which some (like me) are allergic and there's a Metamucil product with Stevia. I use that one, but is more expensive. So read the label.

3) All of the ones I've used have maltodextrin, which is a carbohydrate. There probably are some psyllium fiber products that don't have it - so shop around if you're trying to cut carbs.

4) I have found that doing this consistently works best. When I'm unable to mix a powder in water, I take some (7-8) MM capsules at the water fountain - much easier to manage than carrying the powder form and mixing it.

Hope that helps!

Man I'm sorry you're going through that. My dad's rectal cancer went away after radiation and chemo pills, but then it came back and he doesn't want the surgery and infusion chemo. So it's bad but so far not to your extent. The most he's gone in a day is 8 times, that was once, and usually it's between 3-5.

God bless you

I lost my entire colon due to cancer surgery, which means my feces is always runny (I have no colon to remove the liquid), difficult to control and frequent (8-9) times a day - including overnight events.

Per Mayo Clinic, I was directed to make a barely drinkable slurry of Metamucil (psyllium fiber) and drink it. The psyllium fibers absorbs excess water, helps make the stool more semi-solid and also easier to control. I do a heaping teaspoon in 2 ounces of water 4 times a day. 2 hours after breakfast, 1 hour after lunch, 2 hours after evening meal and in the middle of the night when I wake up for a bathroom run. The delays are to enable absorption of medications which this can impact. If you mix it with too little water, you can even eat it with a spoon much like applesauce although I don't recommend that.

So the normal use of MM is to drink it with lots of water to loosen stools, but it also tightens stools if used in a larger quantity with minimal water.

Some practical notes - some of which would apply to other readers.

1) amount and frequency will vary so some experimentation with quantity and frequency is necessary and can take some time to figure out.

2) Some of the non MM fiber supplements that have psyllium fiber also have granulated sugar which can aggravate diarrhea, I found these unhelpful. There are also some with artificial sweeteners such as aspartame to which some (like me) are allergic and there's a Metamucil product with Stevia. I use that one, but is more expensive. So read the label.

3) All of the ones I've used have maltodextrin, which is a carbohydrate. There probably are some psyllium fiber products that don't have it - so shop around if you're trying to cut carbs.

4) I have found that doing this consistently works best. When I'm unable to mix a powder in water, I take some (7-8) MM capsules at the water fountain - much easier to manage than carrying the powder form and mixing it.

Hope that helps!

Thanks for the details of your regiment.
I'm in the same situation with no colon. (Had a TC-IRA). I've been relying on the pysslium husks capsules (and dancing around medication time effectiveness interactions as you mentioned) but will try the combo because I haven't been taking enough capsules to equate to what you're taking in the slurry. I have an occasional day with very acceptable loose, but solidish BMs, but most days, I have mixed results. And I do have some really bad days thrown in there. (Burning, bile, diarrhea) Still trying to figure this out. Aug will be one year since my surgery. Otherwise, I recovered well.

In addition, do you also drink a lot of fluids throughout the day? I was told to stay hydrated and drink lots of water (sometimes with a few sprinkles of IV Solution powder). Is this counter productive?

My surgeon said to eat 35 gr of fiber a day. Do you count food and vege fiber in your daily fiber routine?

Thanks for the details of your regiment.
I'm in the same situation with no colon. (Had a TC-IRA). I've been relying on the pysslium husks capsules (and dancing around medication time effectiveness interactions as you mentioned) but will try the combo because I haven't been taking enough capsules to equate to what you're taking in the slurry. I have an occasional day with very acceptable loose, but solidish BMs, but most days, I have mixed results. And I do have some really bad days thrown in there. (Burning, bile, diarrhea) Still trying to figure this out. Aug will be one year since my surgery. Otherwise, I recovered well.

In addition, do you also drink a lot of fluids throughout the day? I was told to stay hydrated and drink lots of water (sometimes with a few sprinkles of IV Solution powder). Is this counter productive?

My surgeon said to eat 35 gr of fiber a day. Do you count food and vege fiber in your daily fiber routine?

I have bad days as well so I try to avoid variance from day to day and try to eat/drink/take MM consistently - that variance is what messes me up.

I try to limit fluid intake to a quart and a half unless I'm doing something to cause sweating... drinking over that amount encourages the diarrhea. Today, I was working outside in 84 F heat so I drank more water than normal. Even then, I don't over water because of the consequences. I avoid soda entirely - the non-diet (sugar HFCS) versions encourage diarrhea and I'm allergic to most diet pops. It is difficult to adjust the water and the psyllium husk powder based on activity. I do drink (and recommend) G-zero (Gatorade - zero calorie) or G2 (Gatorade - half sugar) or equivalent. I use this when I've been very physically active.

Yes, drinking lots of water is a good thing for most, but it is counterproductive to what the psyllium husks are doing. I think, but don't know, that you can increase water and psyllium husk powder proportionally if you are thirsty. I've thought about testing this, but haven't yet. I do know if I overwater the diarrhea returns and quickly. Ick.

I don't bother to count my fiber intake in a day.

Hope this helps.