J Pouches, Ileostomy Bags, Colostomy Bags and Diarrhea


Sometimes I get questions from cancer patients who have a J Pouch; usually with the same problem— diarrhea. I don’t have a J Pouch. I have a colostomy bag, which is different than an ileostomy bag. The main difference is, my stool exits from the large intestine and the ileostomy via the small intestine. Both ostomates poop into a bag located outside our abdomen.The J Pouch is internal and is made from the patients small intestine and attached to the anus. They can also hold the poop in via their sphincter muscles when they have to go, just like before when they had a rectum/colon.

Ostomates can’t hold it because the intestine doesn’t have a muscle. Most of the time I don’t know I’m pooping but it doesn’t matter since I’m “going” directly into a bag that will be emptied as soon as I can. Most patients who go for the J Pouch, like the idea of pooping the “normal” way. I think its a matter of cosmetics, but they seem to have more problems than ostomates.

From what I understand, patients with J Pouches and ileostomies need to drink more water. They become dehydrated quickly, even if it isn’t hot outside. I drink extra water too but not as much as them.

I think diarrhea  happens to the best of us, even someone who poops the old way(through his or her tushy). What it comes down to is finding out what foods trigger the event. Since we are all unique individuals, foods that give me diarrhea or “gas” for that matter, might not affect you. Its trial and error.

I suggest keeping a food diary. Its the best way to find out what’s going on. You can also eat one or two kinds of food for a couple of weeks and then add new foods slowly. That way you can find out what foods upset your GI system.

I’ve done it to see if I was allergic or sensitive to a particular food. That’s how I found out gluten is not my friend so I eat sprouted bread instead and I limit how many slices I eat. Before that I could eat an entire baguette smeared wit butter. Some cruciferous foods and garlic (for sure) give me gas, but I can live with that, although my family might not agree.


I found a website that gives advice to people with J Pouches, who have diarrhea issues that you may find helpful. I think its good advice for anyone with an ostomate as well.

Be well,