let me cut to the chase

First of all, if you have an anal stricture forming (pretty common) or cuffitis, you need to have those addressed, as they can cause symptoms of sensations of incomplete emptying. These can come on gradually, catching you by surprise. And, if liquid stool passes easily, but you have difficulty the thicker the consistency, then these may be problems to rule out.

I am closing in on two decades with a j-pouch now and the main thing I have found that is helpful, is patience. I know it seems overly simplistic and stupid, but that is sort of it, for me anyway.

Much of the time I wait until the urge is strong, sit on the pot and a rush of liquid to sort of semiformed stool comes forth, followed by a blast of gas. Usually that means I am done. But, sometimes, particularly if I am on the dehydrated side, the urge is fairly strong, but emptying is not complete, especially if I do not get that last burst of gas. That is where patience comes in. I sit there a few minutes, read a bit, maybe check my emails on my iPad, and wait. I may lean forward, lean side to side, stand up and sit down, but I do not strain. Usually, after about 5-10 minutes, it just sort of comes. If I don't do this, I wind up coming back in in 30-60 minutes.

So, patience is a virtue, even if you do not feel like waiting for gravity to work. But, the pouch does need a gravity assist.

Jan

thank you jan, i had this same symptom just before takedown with just mucus so my surgeon checked and ruled those things out. it happens with liquid or thicker stool. i was told by others that this is normal post takedown but goes away with time. i guess your saying this may not be the case. im really discouraged today and my depression and anxiety are at an all time high. can you tell me if life can be a pleasure in the future because im feeling hopeless right now?

You might try a bidet- the warm water and/or Emma function can really help with emptying.

Yes, there is great hope!!! You may wish to consult your doctor or a therapist to see if an antidepressant and some counseling by someone skilled in working with patients with chronic illness could be of help. Most depression is very treatable, but all treatments don't work on everyone so you may have to be patient and try a few until you find what works for you. An combo of antidepressant plus cognitive-behavioral therapy is likely to work best.

Hang in there-you WILL feel better!

When did your surgeon check you? My stricture formed about a month after takedown. I would have it checked again. Sounds like an awful lot of straining.

i go easily most times but every night its a struggle sometimes right after an easy bm. i am having the exact same symptoms i had pre takedown and was checked after that so i dont think so. i dont get it. ive read so many people say they strained so much just after surgery and it turned out great. man you guys got me so worried n anxious again. i should stop asking this question because i get so many positive replies and then bam im thinking problem again...

I can't remember if you are taking anything to slow down the number of b.m.s, etc. such as Immodium? Keep taking Metamucil if you are on it. It is a b.m. regulator and does a good job of helping to pass stool more easily. Experiment with the amount you take. Just a thought......if you are using products like Immodium......stop. Be sure you are drinking alot of watery type liquids. I know what you are describing and even after 10+ years it happens to me from time to time. My answer to this is to eat an apple. I do agree that a bidet which shoots warm/hot water "up where the sun don't shine" relaxes things enough to empty more easily. Keep experimenting with foods, liquids, etc. It all seems to be trial and error and what works for one of us doesn't always work for another. Crazy, huh?

I don't strain. My point was that there is a learning curve and early on it is typical to want things to progress quickly, and the thing is that adaptation will take however long it takes. Yes, it is frustrating.

I can tell you that much of my discomfort of that feeling like you are sitting on a baseball, that "puckering butt" feeling that comes on for no reason at all, and that dragging sensation like an anchor, 80-90% of that was associated with cuffitis. I ignored mine for years, thinking it was not that bad. But, once I had the cuffitis treated, it has been quite good.

I would be quite wealthy if I had a nickle for every person who said they were afraid they would never improve and always be miserable. Most people come back and say life is good, so do not despair.

Jan

it will lock up even if liquid and yes i take immodium or it way to watery and i get too many spasms to bear without immodium. every time i add metamucil even a little the gas is brutal...

jan, i have not strained since reading your post. i am going to be patient and if it doesnt come out ill go back to bed til it does. wish i had the guts to try n fart laying down cause most of what has me in the can at night is gas...

Well, if there is any comfort in knowing you are in good company, there's that.

I have not dared to fart without being on a toilet, other than the rare occasion that I thought I could, but just ended up needing clean underwear! Some do gain that ability though.

I was upduring the night probably 2-4 times for about 4 years. I am a nurse, and I did not know this was cuffitis. I just thought that was how it was going to be. I had nothing to compare with. I knew there was inflammation there, but my GI said we didn't need to treat it unless it was serious, and I did not bleed much. Just a little splatter of blood at then end of a movement. Seemed puny compared to what my colon was spewing.

So, then I got a case of full blown pouchitis after food poisoning, and just hours after my first dose of Flagyl, I discovered how good my function could be. That led me to believe that my overall function could be so much better.

It is just that this early on, you just cannot tell if it is just a need for more adaptation or if there is inflammation that needs to be addressed. A simple digital exam would reveal cuffitis, so you don't need a scope for that.

Since you are having symptoms that are really troubling for you, I don't think having your surgeon take another look is unreasonable.

Jan

i see a new surgeon on nov 6th so well discuss this. i had my surgery at cleveland clinic but moved home to ny to be back with family and my surgeon hand picked this new guy so well see. i had these exact symptoms just before takedown just passing mucus and the cuff and pouch were all checked n clear right after so i dont think thats it. i think its adaptation but its alot to deal with. i dont seem to be alone in being overwhelmed 28 days from takedown so i need to stay calm and trust im normal. i just think im exhausted and ready to be done with this long butt kicking journey...

Hang in there Tom! I am having a bad day today too, after 4 brilliant days it is a real comedown, but tomorrow is another day!
Caroline