Gravity Smavity..... Gotta push!

have you rule out stricture?

also different positions help. try squatting?

do you take immodium? perhaps stop that.

drink coffee or try grape or prune juice to help things empty out...

Have you tried Metamucil (or other soluble fiber)? Remember that these are marketed for constipation, even though we tend to use them to thicken/bulk up liquid stool. It might not work for you, of course.

even though there isn't a stricture would a dilation help? I'm new to this too, sometimes it's hard for me also but it recently got better with a dilation due to a stricture.  I'm going back for another dilation in 2 weeks because it's not as easy to empty as when I first got dilated. 

Mystic, try asking your surgeon if when she did a scope she was able to just go straight up into the pouch instead of having to turn the scope ever so slightly. 

during my first J-pouch the part where my pouch attached to rectum had a small turn in it, she said resulted from using a staple method. when i went back to an ostomy for awhile it was corrected and im not running into that same issue again. well i was initially but it was because i needed a dilation. 

also maybe your not dilated but inflamed just near the anal canal? that way your pouch looks health and they cant find a stricture but your having those issues..?

It's probaby how your pouch is sitting angled inside you. My sister has a j pouch too and she has this problem. She says (humorously) that she always thinks she's going to pop a vessel in her head from pushing and her husband is going to find her dead on the toilet like Elvis. 

I have a problem with this also. If my stool is anything other than watery I have to push and fiber doesn't help.  I take 400 mg of magnesium a day to keep it more watery so it come out easier.

I've had the same issue since my 1992 j-pouch surgery and it's never been determined why. I was warned prior to the surgery that this could happen. I don't need to push too hard to get going but I always need to push.

I am exactly one year post take down and have output all across the board- sometimes liquid, some formed, and lots in between.   I do find when I have to push formed stool out that using my little squirt bottle - holds about 12 oz., with very warm water helps a lot. I have to refill it sometimes 3-4 times and usually wipe in between but it definitely help me release more stool without pushing as much. I'm sure a bidet could do same thing but this little bottle has made huge difference for me. Also use it to clean up after softer stool output. I squirt it front and back. BTW cold or cool water does not work the same way as warm or slightly hot water. Hope this helps! 

This is exactly my problem as well. Even if its diarrhea I have to strain. I do have pouchitis and have been on cipro, but it started right after my takedown and has never gone away. My pouchitis is also handled with the cipro, so I rarely have diarrhea and don't take immodium either. So frustrating and has led to hemorrhoids and fissures for me!