The first step to fixing it (if it’s not just a functional adaptation problem that will fix itself) is getting a proper diagnosis. If you have a true stricture at the outlet then dilation (sometimes repeated, sometimes maintained with home dilations) tends to do the trick, but I’m not convinced that you have a stricture. Do you have a follow-up appointment scheduled?

I agree with Scott. This may be a stricture or it may be dysfunction of your sphincters. One simple solution is to not let the stool get too thick. But, you don’t want pure liquid either. That will burn your tush for sure. Consistency of applesauce is a good goal. You need some bulk for your nerves to sense, and signal the involuntary sphincter (internal) to open. There may be some “relearning” needed since it has been out of commission so long.

If this does not resolve soon, you need to contact your surgeon to get it sorted out.

Jan

Thanks for the advice.  Since I am only three weeks out I assume (hope) it is an adaption period.  I also had a bad case of diversion pouchitis pre-takedown.  I don’t know what a normal J Pouch should feel like.  I met my surgeon two weeks post op and I mentioned the straining - and he said it will take time.  I don’t have an additional follow up appointment from here, but I can certainly get on his calendar. Thank you so much for taking the time to respond.  Best Doug

Wow I did not have any straining at your stage! I was going like 40X!!! Lol. How much water are you drinking???

I had straining early on and it did get easier. I never felt like I needed to bulk anything up and really had a hard time emptying completely. So for me, standing up and bending over for a few minutes. I still lean forward when I go, with my hands touching the ground. I'm at 15 months post takedown. It's much easier now.

Thanks everyone.  As for my water intake - I am drinking about 8 glasses a day - kinda normal.  Standing up and sitting back down seems to help me also.  It like my JPouch dance.  At three weeks I think I need to just try to be more patient.  Thanks for the comments Lauren and Kmiller.

@Doug K posted:

Thanks everyone.  As for my water intake - I am drinking about 8 glasses a day - kinda normal.  Standing up and sitting back down seems to help me also.  It like my JPouch dance.  At three weeks I think I need to just try to be more patient.  Thanks for the comments Lauren and Kmiller.

That is the problem, you need way more than 8 glasses per day, I have confirmed that with doctors. 8 glasses is normal for colon folks, we need at least twice that (Gallon total) make sure to put extra salt in your food as well. Your welcome Doug

Thanks for the advice on water.

Um, measure your water intake based on your urine output, not number of glasses. If your urine is dilute, you are drinking plenty. We all have different needs. Early on you need more and after your gut adapts to not having a colon, you will need less.

Some people get stressed by thinking about how many glasses of liquid they need to drink in a day. You can do that, but not needed.

Jan

My urine is definitely dilute.  I think I am good on the water intake.  Either my rectum/JPouch is still adapting, or I have a little narrowing.  Over time I think I will be able to figure it out.  I am going to get an appointment with my surgeon in a month. Thanks

@Doug K posted:

Thanks for the advice on water.

Your welcome

I don't know if this will help or not but you are only 3 weeks out. It is all brand new. It takes a while for everything to settle down. When I first had mine it seemed like every few days something new would start that I was worried about then as soon as it started it stopped and another new thing would start. I wouldn't sweat stuff just yet. Give it a few months.

Jaydog- you are a wise man.  Nothing is smooth sailing when you cut out your rectum and colon, and make a new one out of a nearby organ.  It could be worse for sure.  I spoke to the doctor and he said give it two months, and if I am still unable to pass solids well, he would do some tests.  He said that dilation is not a big deal.

@Doug K posted:

Jaydog- you are a wise man.  Nothing is smooth sailing when you cut out your rectum and colon, and make a new one out of a nearby organ.  It could be worse for sure.  I spoke to the doctor and he said give it two months, and if I am still unable to pass solids well, he would do some tests.  He said that dilation is not a big deal.

Ya like I said in my experience I had tons of little issues. I would post on here and ask for advice and before I could read the responses my issues would go away and I'd have some type of new issue. If I remember correctly around the 3 months mark is where I started figuring things out a bit