Hi, Sunflower. I’m sorry you’re going through this, and it does always seem like holiday weekends are magnets for trouble. You’ve made a good list of possibilities - you might add cuffitis as another possibility, since most of us still have a small rectal cuff that the pouch is stapled to. Most folks seem to do best with a compromise between liquid and formed stools, with a texture like pudding. If you’re getting pieces then it’s probably too hard. It might be as simple as drinking more water. Only experimentation can tell you whether soluble fiber (like psyllium) makes things better for you. If you try to change only one thing at a time you’ll have better success figuring this out, but unfortunately that can delay a solution. Folks who’ve used lidocaine internally for the pain can perhaps tell you more about how it worked and how to get it.
Some things that might help, and are unlikely to do any harm, include warm sitz baths, plenty of fluid, and (as you’re doing) patient relaxation on the toilet. I hope you get some relief.