I have found using my hands to massage and push on the pouch helps empty it more completely, though with the peristalsis of the small intestine tissue, you can never be sure there isn't more to come in the next minute or two. 

Thanks Sara.  I should add, I've stopped taking all fiber.  Thoughts anyone

When I take a small amount of organic psyllium husk powder before each meal (1 heaping teaspoon) paired with plenty of water, I find that my poop forms a more cohesive mass that sticks together but not to me, making wiping a cleaner & easier affair.   I also find that it slows down my output to a reasonable rate.  It seems to be a great regulator of digestion.  Each person seems to vary as to how much and when they take it.  When I don't eat fiber, I find my bowels are sluggish and sticky feeling, like I can't ever really empty them.  When I eat too much of the wrong kind of fiber (not soluble, not finely ground or easily digested), the waste rushes through and the intestines get sore.  Sometimes, even with the psyllium, my stools are watery and frequency increases.  I don't worry about it if it happens here and there, but if it goes on, I generally look more closely at what I'm eating and defer to soothing fiber (like oats) and probiotic foods or capsules.  Decreasing caffeine intake, avoiding raw veggies, and reducing sugar & alcohol can also help during these times. 

OH, and also, if your butthole is too constricted and you want to try the enema, you can help it relax by massaging the area and by sitting in warm water.  Soaking in epsom salts in hot water may help as well.

Eric, what diameter is that enema tip? Is it possible, that you need to have your pouch outlet / anal canal dilated? You should at least be able to get a finger in. If only fluid can get through that is not sufficient.

Thanks Steve.  I will ask my doc about it

@Eric in Seattle posted:

I’ve had a pouch about 8 months.  One of my challenges pre takedown (pouch in place but not connected) was that I had pelvic floor issues that would make emptying my pouch difficult.  I saw a PT who was able to help train my muscles to learn how to push things out of the pouch.  

Now, unless I drink lots of coffee to get my stool very liquid, it’s hard to empty my pouch.  

If my stool is liquid and coming out, how do you know that my pouch is empty? My guess (sorry graphic) is when the stool is followed by gas coming out?  Doc suggested enemas if I was really stuffed up.  The problem with that is my anus is so tight it’s hard to get the enema tip in my rear?

Any ideas folks?

Thanks as always,

Eric

Do you lubricate the nozzle well! It requires a little push.

Hey Eric,

it took about 8+ months before my pouch empties in one sitting. Before that time, it would constantly fake me out.

i would clean up and then get the urge again.

Nowadays, I take Imodium 3x/day to lessen butt burn. Sometimes, but not often, it will constipate me and I really have to sit along time to get things going.  I like looser BMs, as they tend to clean out my anal canal and not leave stool and subsequent irritation in there.

I am not a fiber person, but my surgeon did tell me warm water enemas are always ok; and they do work when I try them.

if you are very tight the surgeon might be able to dilate the canal with his finger.  In fact, on my last visit to surgeon he likes to check and feel the anal anastomoses; and sure enough he dilated the area with his very big fingers 😫.

@Eric in Seattle posted:

I’ve had a pouch about 8 months.  One of my challenges pre takedown (pouch in place but not connected) was that I had pelvic floor issues that would make emptying my pouch difficult.  I saw a PT who was able to help train my muscles to learn how to push things out of the pouch.  

Now, unless I drink lots of coffee to get my stool very liquid, it’s hard to empty my pouch.  

If my stool is liquid and coming out, how do you know that my pouch is empty? My guess (sorry graphic) is when the stool is followed by gas coming out?  Doc suggested enemas if I was really stuffed up.  The problem with that is my anus is so tight it’s hard to get the enema tip in my rear?

Any ideas folks?

Thanks as always,

Eric

Are you using lubricant? Enema or irrigation has been the best answer for me after stg 3 colon cancer!