I have that pressure at times.  I have had my J-pouch for six months so I was hoping this would get better in time. It can be intense at times.  Some days are good and others not.  I take probiotics daily, is the VSL 3 more helpful?   Is the fasting something someone recommended?  I eat less and not after six pm usually.  Lori

Simplex You are not alone. I've had my  j pouch for 16 years. Have struggled with pouchitis over the years. The last 2 years I've been experiencing  terrible cramping , pressure and urgency. I've tried so many different approaches. My Dr says it's a stricture and I need to drink Konsul to create bulk. But! That creates gas and cramping. The pharmacist I work with suggested Equalactin. I found it on EBay. Still trying to figure out how much and when to take it. I also bought Heathers Tummy Tamers on the recommendation from someone on this site. Seemed to help the first several days....but I'm still very frustrated. I dread eating! I think I'll stick to a low residue diet for a few days to let everything rest. Have you had a stricture before? How did you handle it? 

You are all describing my life.......last month.  After about 15 years with my J-pouch I still am unprepared when things are out of ordinary!  Pressure in the anal area is one situation which typically doesn't occur with me is of concern when it does happen!  I call my surgeon who I rely on more than I do with my GI doc.  Sometimes we connect and other times we don't for several days.  This last time we didn't connect for days and by then, my symptoms were almost gone.  All I did was switch to a soft diet/liquid diet and take it easier than usual.  I couldn't get into see my colorectal surgeon for several weeks but decided to make and keep the appointment even though I was feeling fine by the time the appointment came.  He examined me and said all he saw were some polyps.  Maybe what I had experienced was a simple upset stomach!  (My conclusion, not his!)  I'm just very grateful I'm back to "my" normal!  It is a journey, isn't it?