Trisha,
I’ve had my pouch just short of 5 years and have had a prolapsed pouch for 3. It was worse, protruding significantly, but has gotten better. I try not to strain, use warm water to help me evacuate, and have had some improvement in overall frequency by following the FODMAP diet. Also, I had a pouch advancement, mucousectomy and removal of a flap that was also prolapsing 2 years ago -Things somewhat better, prolapse not every day nor as severe, but only real option is removal of this pouch and creation of new one. I am having a Medtronic Interstim Neuromodulator implanted this week to HOPEFULLY improve my ability to evacuate, thus reducing frequency and leakage. Maybe this will also reduce my prolapse.
good luck!
laurie