I think the risk is minimal of pouch prolapse, where the pouch pushes thru the anal canal.

early on I asked the surgeon if i could cause problems from all of the pushing and straining I was experiencing. He told me no.

Although I did manage to aggravate an old inguinal hernia repair, my pouch has been just fine from my occasional excess pushing.

What is a pouch prolaspse?

Yes, you can injure yourself by straining. The most common problems are hemorrhoids, but you can also cause a pouch prolapse or aggravate an anal fissure. Difficulty emptying is sometimes from stool that is too hard (true constipation), but more often it’s from something else, such as a stricture, pelvic floor dysfunction, or even a blockage in the small bowel that feels like fullness even though the pouch isn’t full. I think it’s probably time to visit your GI.

Straining may cause or indicate a problem, one that can be fixed -- just not by more straining.

There are different types of prolapse.  Straining aggravated my mucosal prolapse in that area which  interfered with passing stool and lead to more straining. Until I learned not to do it, and to rely on abdominal and pelvic floor muscles instead.  

Have you been scoped recently?  

In the short term,  increase fluids, perhaps limit insoluble fiber and foods that slow you down to get the stool softer.   A bidet (portable if need be) can relax the pelvic muscles and also may help with the bleeding you describe.  

I'm going this Friday for a pouchoscopy.

Glad to hear it.  Hope you'll let us know what you learn.

I've had the same issue.  My GI referred me back to my surgeon.  Surgeon sent me to pelvic floor Physical Therapy.  They also suggested using something called a "Squaty Potty".  It's basically like a step stool to put your feet on while you go.  It helps to put your body in a better position for the pouch to empty and eliminate the feeling of needing to push.  Just a thought.