There are a few possibilities, but it’s probably not pouchitis. It’s important to try not to push very hard - it can make some problems worse (like pouch prolapse and hemorrhoids), and it can add problems to whatever you already have going on.

Let us know what the doctor says.

Yeah please stop pushing so hard even if nothing is coming out. I had once very little blood come out when I had pushed too hard, my surgeon strictly asked me to never repeat it. 

Somethings you can do at home to cure constipation is take a light laxative like black coffee, pysillium husk with a glass of milk ( believe me this one is the best ). Relax your butt everytime you sit on the seat let the pressure to go build up without trying to push. I sometime sit in weird yoga poses to get evrything out without having to push. Take deep breaths everytime you think you have to push.

I hope you find these a little helpful.

Could be a stricture, narrowing in the rectum. 

Went to my doctor, he wants me to go in for a pouchoscopy on Friday. He said he didn’t want to bother torturing me by looking at anything now and quickly mentioned that it could be a narrowing, but I guess we will see.

Yes I had a problem like that now I 68 years old and had my pouch since 2011 I had protrate problems I went to the  ER and found I couldn't pee in a cup because of the prostrate wouldn't open with all that fluid in my bladder wighted down on the J pouch cause that problem of a simulated constapation now I was put on flow maxs and it helped with Cipro then found out that we with J Pouch are more prone to pass kiney stores after I pass one earlier this year  and a short time later I begain to fill the toltoi with blood this lasted for 24 hours and went away I think they proscrbed morfren and  I had a reaction to the pain meds from ER I have a scope coming up on May 9 with the stomach check as will 

Pouchoscopy went well. Doctor said no strictures, and he isn’t quite sure why I was having issues. He gave me Canasa suppositories for 30 days and told me to go back to see him when I’m done with them. Took a tissue biopsy just to be safe. Weird. Symptoms have gotten better though, and actually started improving the day before my procedure.

My best guess is that this has to do something with the weight loss drug you were on. I had severe constipation when I was on Cipro. It was exactly how you described. Key point - i stopped it right away after a week course and it still took me two weeks after to get anywhere close to normal.

i still have constipation time to time and my go to has been prune juice. Any other suggestions would be highly appreciated...