@RodD we’re on the wrong thread, but: when was your last pouchoscopy? DO you have a GI who has an opinion about what’s going on? Can you tell for sure whether you have 1) incomplete emptying (plenty in the pouch that just won’t come out), or 2) an urge to empty a pouch that’s pretty much empty already? These can sometimes be hard to tell apart. Both of them lead to unsatisfying visits to the toilet, but the causes and treatments are very different.