Time Spent In Bathroom / Difficulty Emptying Pouch

David-

This helps clarify your other post about gas pain. I can think of a few things you might consider.

1) In a coloned person muscular contraction of the rectum helps produce a bowel movement efficiently. J-pouchers have no such musculature, and have to depend on gravity and intra-abdominal pressure to empty the J-pouch. Some folks take to this naturally, and some have to work harder at it, sometimes including biofeedback. For example, if the sphincter tightens when you’re trying to empty, nothing good will happen. This could also explain the pain you describe in your other post.

2) I think I recall from your other post that you’re taking Imodium. I’m not sure what you’re trying to accomplish with the Imodium, but I’d suggest stopping it for a couple of weeks. See what effect that has, at least.

3) You are very likely to have (or develop) significant hemorrhoids from the amount of time you’re spending on the toilet. At this point that might be a significant source of the external pain you describe.

4) J-pouches sometimes have structural problems that interfere with emptying. Some of these (such as pouch prolapse) are mechanical and occur only during (attempted) defecation. Pouchoscopy doesn’t help make this diagnosis.  Defecography is a test that images the pouch during defecation and reveals what’s happening right then. You might be ready for that.

5) As an interim measure, to get you some relief, you might consider pouch irrigation as a way to empty your pouch. There are also a few folks here who always empty their pouches that way, but I consider that a last resort. It’s probably better than pouch removal, in a sense treating a J-pouch like an inconveniently located K-pouch.

Good luck!

I was being quite constipated on the last november, it became really painful and , and disappointing, I solved it adding cooked vegetables (turnip greens which we have many here in Italy) one evening I flushed much more stools and then in the next days I still ate cooked vegetables, lots of yoghurts, some salads, and I solved the problem (still had pouchitis). I advise you, also, to try psyllium fiber . The cooked vegetables are to be cooked in olive oil or butter and you can add garlic, really yummy ! I forgot, I'd really stop imodium in your case, I suspect it could even be the cause of the problem.

Diet is so extremely important for a pouch to function at its best. I have had my pouch for 5 years now and through alot of trial and error I have it working well 95% of the time. I find for myself that the more vegetables i eat the better.  I eat alot of  soft steamed broccoli, cauliflower,  and brussel sprouts.   I ususlly have 2-3 salads a week.  I make green smoothies with baby spinach, ginger, cucumber, plain greek yogurt, peaches with a touch of honey and water.  The smoothies get everything flowing easily.   I also find that a low carb low sugar diet is the best for me.  If i eat too much proccessed food it makes empting very difficult.  I try to drink 1-2 glasses if water with each meal.  My favorite breakfast is soft cooked oatmeal with blueberries that i heat up in the microwave for a couple of minutes and a nice dollop of real whip cream.   Again i would like to stress how important your diet is.   I hope this helps.

You may be suffering from Fissures within the Anal Canal.

A day or so after my takedown surgery I experienced a similar sensation as yourself, kinda feeling like I needed to go but nothing happening and once I finished, I'd have to dash back and start over; at the time I didn't know what expect but I had the sensation of needing to pass something more than what was coming out, which was never ending.

I managed to apply ilex paste just within the Anal Sphincter which provided instant relief of the pain and discomfort and also stopped the desire to keep opening my bowel.

However, on the ilex Paste packaging, it clearly states For External Use Only, so bear this in mind, although for years, every so often, I've applied the ilex Paste internally and without issues.