Sonny, at 6 months you shouldn't be having trouble emptying your pouch. I think the single most important questions for your surgeon may be "why am I having trouble emptying?" and "why am I having urgency?" The surgeon can do an exam and possibly schedule a pouchoscopy to figure it out. If the surgeon can't do this then a good gastroenterologist might. If your surgeon is any good you shouldn't have to figure out whether you need dilations or not.

Hi, Sonny. I know the confusion you feel remembering your lifestyle before your cancer diagnosis and j pouch. I felt the same way. The good thing is your cancer was discovered and removed, and you are in a very, very good position except for burning and frequency, something you never had before. Hopefully, and only for a short period, these symptoms and setbacks are your new way of living until your body adjusts and becomes used to your new plumbing. You lived your whole life one way, and now your body and everything in it that depended on your colon has to find a way to adjust and figure itself out. Be patient. Did they tell you it could take one year for your body to settle into a new routine? That is okay.

Make a list of all the questions and concerns you have and bring the list to your appointment on Monday. There are no silly questions. If it scares you, ask it. You are the CEO of your life, and your surgeon / doctor / gastroenterologist works for you. You are the boss. Ask your questions. If you don't understand her answer or if she is vague or impatient, ask her to please explain it again so that you can understand it. It's okay to be scared and confused; it is not okay for your medical team to let you remain confused or not 100% informed. Expect answers, ask the questions until you are satisfied. Maybe they do this 100 times a month, and you can acknowledge that, but you are doing this once in your life and they must help you get it right. Or look for a specialist who can. Don't live in fear or confusion or pain.

When you say you are going for your six month checkup, do you mean an internal scope, or just to see your doctor?  Ask your doctor if she can schedule an endoscopy (a look around inside your pouch) so she can look for inflammation, pouchitis, cuffitis, or anything, just to rule things out. My scopes are every six months. If you are nervous about anything being inserted during the endoscopy because you are experiencing pain or swelling, ask them to sedate you. I welcomed the sedation because I was so sore. You won't feel a thing and you will be fully awake 1/2 an hour later. They might give you cookies and juice when you wake up   Do you use a bidet or spray bottle to keep the area clean and dry, and apply a barrier cream every time? That will help so much to soothe your burn and irritation. Don't use dry toilet paper. Try unscented baby wipes or moistened paper towel (don't flush these or your home's plumbing will have a whole other set of problems!)

Did a dietician come to your hospital room to speak with you about food and diet? You might ask for an appointment to see her again. She might ask you to keep a food and drink diary (or start one for yourself), and chart your body's reaction to see what irritates your j pouch. I avoid nuts, seeds, raw vegetables, sugars. Trouble emptying might be from swelling inside, or hemorrhoids, because you are straining. Do not strain. Be patient. Try again later. Drink lots of water. Let go of your stress, take control, ask your team for help. Start your list of questions, and write down her answers on Monday. She will see that you want and need to be completely informed. Good luck to you on Monday.

I could not have said it any better than winterberry.  I always have someone with me (my wife) when I meet with the doctor and make sure all of my questions are answered before he leaves the room.  A good doctor respect this.  Before having a scope exam when I am sedated, I always give my GI a list of questions about his findings and he writes brief responses.  I do this because the sedation given impairs your memory for a short period of time.

Winterberry I'm totally speechless for the amount of time you invested in this well said well thought out message for me I'm completely overwhelmed by this response and a thank you to you I feel doesn't say much but I'm very thankful for this message. This Monday is only a 6 month check in a scene of talking about our upcoming steps I guess to get to following exams at least I think so.. This whole new way of life has been confusing and heartbreaking for me but I'm grateful to be Alive since my surgery in December I'm now a grandfather of 3 and I'm 41 so I have a lot to live for and look forward to it's just I'm a   Inpatient  person and waiting for my body to adjust but I have to I have no other choice bottom line I will take your advice and make a list of questions on what are my concerns about my health again like you said my body I'm the boss . I did meet with a dietician I didn't really get anything out of it my problem is I'm a foodie and a self taught cook on the fattier happier kinds of food lol .. So I broke out my shell and I'm eating anything I want except for spicy foods I do keep away from raw fruits and vegetables nuts I am heavenly scared of those 3 .. I tried the food diary and honestly I failed miserably because no matter what I ate at that point in my life I was still in the toilet so I gave up too many things were against me being Italian and living outside of Philadelphia with cheesesteaks and being a cook so I threw in the towel on the diary .. First I was scared because I couldn't gain a pound I went from 225 to 178 now I'm 195 I'm only eating carbs morning noon and night to have a solid stomach through the day ... As for the rest of the questions you asked me I do own a bidet and I use Calmpostine on a daily basis but like I said the past 4/5 days I've experiencing this tender throbbing pain back there and I don't know what's causing this and yes I'm getting stressed out because of it and I pray that days week and months ahead that I can finally come to terms and accept my new lifestyle and not be so down about it also too I see my family and friends that live from Boston to Miami on Instagram and I see them living the lifestyle I use to live and I know now that's a thing of the past for me. But I must say my wife my family God and Jesus and wonderful people like you and many others on social media and jpouch forum have given me so much hope and confidence to try to be the person I once was and I thank you all from the bottom of my heart I'm so grateful for this site and having such knowledgeable people reaching out to me . Again winterberry thank you so so much God bless you and I will take every bit of advice you wrote for me..thank you .. Sonny 

Hi, Sonny. You are welcome. I'm pleased that it was helpful for you. You are still the same person as before your surgery. You have a j pouch, that's all. No one will treat you differently unless you behave differently. Remember you will be part of the Instagram photos next year, if not sooner. Take one day, or one hour, at a time.  

Be careful eating a lot of carbs at every meal. You don't want to end up with high blood sugar and diabetes, which will bring a set of health issues such as high risk of stroke, heart disease and high cholesterol, difficulty healing. If you eat a lot of carbs, make sure you eat it with a protein or a fiber (if you can tolerate fiber at this time) to slow down the carbs turning into sugar in your bloodstream. My first meal home after surgery was rice with a soft cooked egg on top, all mashed together with soy sauce or tamari seasoning. I ate this way at every meal, changing the egg for fish or chicken or steak, or tofu. For fibre I had well cooked broccoli, or spinach in bone broth. Does your family make bone broth? Add chicken and rice and spinach to a bowl of bone broth and you have a nutritious soup. I thought the carbs in the rice would send my blood sugar skyrocketing but I couldn't eat anything else so soon after first, and second, surgeries. After my takedown, my GP did bloodwork and found my A1C blood sugar level was 6.5, which is great. I think all the protein with the carbs even things out. Sonny, have your carb comfort foods if you need it, but incorporate protein and some sort of soft, soluable fibre whenever you can. Think of your j pouch as your life-saver, and not so much as a life sentence or separating you from your friends and old lifestyle. Be very gentle and very good to your j pouch. I still have issues after five months. Eat gently and cleanly so it doesn't have to work so hard. Think of your j pouch as trying its best to change its life too. It wants back its old life as a small intestine, but it's doing its best to become a colon for you. Good luck on Monday!

Not sure if this helps you but I often deal with thick stools that don't empty good from my pouch when I get into dairy and I haven't taken my pill form probiotics.  The probiotics keep my bad bacteria under control and bowels flow smoothly.  Just taking a little bit 1billion helps.  Probiotics are huge pouch relief!!!!