How far along are you with your pouch? I'm at 23 years. My GI guy and surgeon both said that after about 20 years, the biopsies they send from pouches look more and more like colonic tissue (he had a name for the conversion, I can't remember it... said if they don't tell the pathologist it's a pouch from small bowel, they can't tell and think it's large bowel mucosa). My pouch is sometimes *too* efficient these days with water absorption. I've never ever needed fiber supplements or Immodium or Lomotil, or things like that... so I always tended to have thicker output than some. The docs both agreed that this can happen (better water absorption), and thicker output.
However, I also had a stricture that made going COMPLETELY horrible and difficult to pass. But you had a scope and exam, so that's likely not your case (I would suppose they would find that). For me, I had a few dilations under anesthesia. My surgeon just examined me Monday, and said all was good, but I'm still having mild trouble sometimes passing stool. Mostly because it's thicker.
I had to really edit some foods, too. I used to be able to eat ANYTHING, but things that don't break down are no-nos for me these days and include: corn, peas, Chinese vegetables, nuts, seeds, quinoa (ate that once, thought I was going to DIE), mushrooms, granola... For almost 20 years, I could eat all of that stuff; now, I don't even chance it.
But sometimes, when things are too thick, I take Milk of Magnesia, in a smaller dose than recommended. It's a non-stimulant, and the only one I can take that doesn't cause me awful cramping (though I've not tried Miralax, either). I usually take about 5-10 mls, at bedtime. This does often cause me to wake up around 3am, but I don't normally care. If it's REALLY bothering me, I'll do a small Fleets enema (I save the bottle and just refill with tap water), and that's often enough to get out what's bothering me in there.
I told this to the GI guy, he wasn't too concerned, and he said that it's ok to do these things if I need to. Today, I started out a bit thick, got most out... then after breakfast and lunch, I went, and things were passable and fine. Didn't have to do any MOM or Fleets for it, so sometimes it's also just a time thing for me.
Hope this helps.
