Hi, I'm a 32 year old woman and I got my J pouch in 2012 at the Mount Sinai Hospital in New York City. I had a confirmed case of UC.
I often have to push very hard when I go to the bathroom, especially when I have gas. I always just assumed it's normal because the small bowel doesn't have the same kind of muscle movements that the colon has. I mean it has peristalsis like the colon does, but I can't consciously cause the peristalsis contractions like I could with my colon. I haven't really had much of a problem with pouchitis.
So I have to overcompensate by pushing my abdominal and sphincter muscles harder. I also usually push on my stomach with my hand to give the muscles something to push against and create more pressure.
I often have this annoying very vague feeling that there's just a little more poop or a fart that's sitting just above the point where it wants to come out and it just won't move down. The feeling is always so vague that I still often question whether it's just my imagination. Even though at this point I should know it's not, because it's proven itself not to be. I know people will disagree with me I think it's because the small bowel doesn't have the same nerve endings as the colon does and therefore doesn't feel as much sensation as the colon does.
Getting up and walking around for 10-20 minutes often helps, but that's not so easy to do when I'm at work and don't want people to see me going to the bathroom repeatedly. By far, the most helpful thing is Metamucil. When I have enough of it in my system it helps this issue a lot.
So to get to the point - the reason why I posted this - It scares me that years of straining like this when I go to the bathroom could one day cause a stroke or heart attack when I get older. I'm concerned about the fact that I'm so often doing something similar to the valsalva maneuver and raising my blood pressure at least temporarily in the moment. (It was normal at my last check up) I try not to do the valsalva thing, but it's hard not to do it. Sometimes my heart rate goes up or my face gets flushed when I do this. So:
1.Is it normal to have to strain this much when you haven't taken any Metamucil or other thickening agents? Or to have to sit on the toilet for an hour every night, waiting for a gas bubble to finally decide to come out? (btw, I've seen the advice on here about standing up or coughing when this happens. That doesn't work for me.)
2. If you strain a lot, what kind of damage can it do to the pouch?
3. Can you get a stroke or heart attack from it?
4. Can you cause liver problems from straining by causing blood to back up in your liver when you do it? (or in any other organ)