People with Fecal Incontinence: Psyllium Fiber?

My problem is that I have to do this for dad. He won't participate in his own Healthcare.

So when I need information from him he sometimes tells me something useful and sometimes hides stuff from me.

So far what seems to be working is immodium/lomitil, psyllium fiber, moderate water, and no caffeine, and no artificial sweeteners. And by "work I mean" 3 accidents a day instead of 6

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.

Thanks so much. My one gripe about this surgery was no substantial after care nutrition advice. My surgeon prescribed Cholestyramine because of the constipation side effect. I'm not taking it because of other potential side effects and I want to work with the husks first. I've just been overdoing the fluids and under-doing the husks. Your advice is so helpful.

I experimented yesterday with increasing my p husk capsules and it did make a difference, at least in the short term. I'm going to follow your suggestion about fluid intake and have measured out my daily water allotment. I believe that I was nervous about hydration and small intestine blockage. But, I'm willing to give it a try.

I also eat all bran with blueberries in the a.m. and it helps.

Do you eat anything you want or do you limit spices or other foods? I get very confused about what to eat and read about SIBO and the FODMAP diet. It feels overwhelming. Any thoughts? Do you take any probiotics or digestive enzymes?

Since I have genetic recessive mutyh-associated polyposis (MAP), I need to get a sigmoidoscopy (even tho no sigmoid, but he can check the illieum for polyps). Also, get an upper endoscopy annually to check for polyps. I trust my gastro, but very nervous about doing the prep..since it will put system into a loose mode.

If you don't mind, I may post an update after a few weeks. There aren't many of us around with a TC.

Thanks again!

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!

@rjjacobsen I saw your post come up in a psyllium search on Mayo Connect. I don't have colon cancer, am in a different group for IBD, I have a jpouch (no large colon) due to ulcerative colitis which began 40 years ago, I got my jpouch in 1996, then diagnosed with crohns in 2002. I have done quite well with my jpouch & bowel control up until about 30 months ago, when I began having fecal incontinence while asleep. I have been on meds for inflammation, and also have taken loperamide & metamucil, and some of the fiber capsules. At this point none of them seem to be working very well, daytime hours are fine it is just at night, I wake up 2-6 times per night, some are better than others. I have read where the whole psyllium husk because of the sugar in some of the other products. I appreciate the info that you listed and just ordered the Organic India brand. I may have other issues going on, but don't have an appt with my GI until mid April. I'm not sure if this is too personal, but wondering if you have a jpouch or an ostomy? I am thinking I may end up have an ilealostomy in order to have more control. I wish you the best. My husband passed from stage 4 colorectal cancer in 2008 that was undetected until it was too far along. #coloncancerawareness month is so important. Blessings to you.