I also strain when going to the bathroom at times, but it can't be helped sometimes its just difficult to try to get it all out, its frustrating but does not happen all the time. Unfortunately, when the irritation goes away for a while, it comes back all over again. Balmex does help me, my doctor gave me analpram HC a hydrcortisone that has numbing and help with inflamation at times. I am so unhappy in spite of all the problems I have had with j pouch, just found out I have bladder cancer, although they say its topical and I will be okay, sometimes I find myself so down and depressed, but try so hard not to ponder on the many problems and discomfort.