I’ve been struggling with my Crohn’s disease lately. Having a J pouch and Crohn’s is complicated I know. I’m currently on multiple medications, supplements, diets, and natural remedies. I’ve been doing really well up until recently. I’m having extreme difficulty emptying, doing my best not to strain. At night I’m leaking significantly, during the day just a tad. I’m having trouble with pain on my bottom as well. I keep everything very clean, have wipes, a bidet, use aquaphor to reduce friction. Every time I THINK I have to go, I can’t and it’s just starting to become frustrating. I was curious if anyone else has any advice or has felt with anything similar? I know all pouches are different
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Difficulty emptying can drive us nuts - I'm sorry you're going through this. Is it possible that your stool is too solid? That would usually be pretty easy to fix. Some of the possible causes (e.g. stricture, prolapse, pelvic floor dysfunction, floppy pouch) really would need the assistance of your doctor, and no assortment of supplements, diets, and natural remedies will help much. Has your doctor offered an opinion?
In the meantime straining to empty can make some things (like prolapse) worse, and can create some new problems. If you need an immediate fix, some people are able to empty with a tap water enema, if they're able to get liquid out. Others need to irrigate with a catheter that lets the fluid out on its own (but solids can clog the catheter).
Good luck!
Those kinds of symptoms which you have described I have had in the past with poorly controlled pouchitis. You haven't elaborated on what meds you are on and whether they include antibiotics which, potentially, could be losing their efficacy. I have actually developed symptoms of difficult evacuation when trying to go cold Turkey off antibiotics in the past. I recently tried going off Vancomycin and experienced something similar albeit not as pronounced as in the past or as you have described.
I once got an explanation on this from a past GI doctor that the pouch when inflamed loses its elasticity and doesn't function as it's supposed to. When was the last time you were scoped?
It is also possibly floppy pouch and/or the other issues noted above by Scott, if proper treatment/antibiotics is being given.
Straining for me doesn't work as it seems to close things off. In order to get things moving, I apply a bit of pressure with a closed hand on my abdomen directly over the pouch area and it works really well in getting things moving and I have no trouble emptying. I also have crohn's and a somewhat shrunken pouch as a result of the associated inflammation and a stricture needing annual dilation. Unexpelled gas is also a problem for me when trying to empty and I try to get rid of gas beforehand. Anyway, this technique has worked for me for years.