Imodium yes or no ?

urgency would almost suggest to me that you might have cuffitis, ie similar symptoms to ulcerative proctitis, and if they left a little of rectal cuff which they often do, or did, not sure if they still do, then its not unheard of.

the cuffitis would best be treated with suppositories. ive never had it, but I ve read numerous patients battling this.

I also think I mentioned this on your other post, I am not sure Metamucil wafers might be working for you, think of it this way if things are flying through, does your body have time to break down the wafers, it might just be better to suck it up and mix the powder and see if that works better for you. it might not be the same but decades ago, they introduced fiber pills this was way before they got fancy with wafers and what I noticed was the pill in the bowl, that's when it became clear to me that the powder was a better idea.

I had the same experience as DEWEYJ with the Metamucil capsules, but the wafers worked fine for me. I stopped using them because I didn't want the extra calories.

It's possible to develop pouchitis promptly after surgery, but it can be tricky to distinguish it from normal adjustment. A new pouch tends not to have much capacity. I was instructed to (gently) try to "stretch" the pouch, basically by delaying bathroom trips a bit. In the early days I would sometimes experience significant pressure/discomfort while delaying a bathroom visit, but the pressure wave would generally pass without an accident. These days, many years later, I can still have that uncomfortable experience if I delay too much, but in a strange way I like it - it tells me that I really can control my bathroom visits. I'd suggest trying to figure out whether your urgency is a matter of discomfort or a matter of a mess. Others will have additional suggestions. Good luck!