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Frequency and Butt Burn in Pregnancy (oh and Vaginal Delivery Q)

Hi guys,

I'm 25 and almost 1 year post takedown--26 weeks pregnant! It was unexpected as my husband and I thought (due to research we read about IPAA and J-pouch surgeries that I would have problems conceiving. That doesn't seem to be the case, whether because we were very lucky or perhaps because my surgeries were laparoscopic--there is very little research about how laparoscopic IPAA affects the established infertility % post surgery, so no way to know for sure I guess...) 

Anyway, we are very happy. And it has been a surprisingly easy pregnancy. I feel very blessed. I experienced very little sickness, and my appetite has been voracious. I was slightly underweight before pregnancy, but I have already put on 30 lbs during the past 6 months, which we think is a good sign! 

However, from about the beginning of the second trimester I have experienced increased frequency, along with terrible butt burn and itching. I was going about 5 or 6 times/24 hours before getting pregnant. I did have a bout of C-diff come on about a month after takedown (we thought at first pouchitis, but I had had C-diff when I had UC and my GI's test for it was positive. I took 4-5months of Vancomycin, and I was still taking it when we conceived. It completely cleared up the C-diff and bad symptoms.) When I had C-diff with the pouch, the symptoms were terrible--frequency and urgency, but the worst part was more the gas pains and problems evacuating the pouch. 

I am now going twice as often as I was before pregnancy...roughly 12 times in a 24 hour period, with 4 or 5 of those at night. I don't really have any pain, and I am also able to pass gas normally without leakage (that was a big sign of C-diff with J-pouch for me.) But the constant going is murder on my backside. It is constantly raw, burning, or itching--sometimes even bleeding when I wipe. The bleeding seems to be all external, not internal from the pouch, and I don't think the frequency is related to food so much as to the shifting of the pouch, pressure, or hormones. My diet is the same as pre-pregnancy, and I rarely had butt burn then. I also seem to have made the issue worse. I tried a handful of popcorn a few nights ago, and I am now having more butt burn, loose stools, and even some leakage (during the day, not at night.) I have been pretty much unable to eat nuts, hard seeds, kernels, or uncooked leafy greens since takedown, but (sigh) I am a big lover of popcorn and salad, so I occasionally try a few bites to see if I can digest it now. The answer is obviously still no, but anyway--

I have combed the site looking for butt burn suggestions, but I wanted to add my own question because none of the other threads were specifically asked about butt burn during pregnancy. So, for those of you who have been kind enough already to read my rambling, here are some questions for you:

1. Did anyone else experience increased frequency and butt burn during pregnancy? If so, what (if anything) helped get it under control? 

2. Is it possibly pouchitis? (I know no one here can diagnose, but if it sounds like a possibility, I will need to figure out a way to make an appointment with a doctor asap/what meds to take during pregnancy. I don't really want those added stressors if it seems unlikely. Plus, money is a big concern right now, so any doctor's co-pay I can avoid...the better.)

3. I haven't seen any posts with people reacting to kernels, nuts, and greens exactly as I do. Does anyone else still have major problems with these foods? Did those intolerances every go away for you--maybe a few years post-takedown?

4. My OB really recommends vaginal delivery, and I would like to try for it. But my surgeon last year had said only ever to have C-sections. I now live about 8 hours away from that surgeon/hospital. I have a GI here, but I have only been able to see him virtually since this COVID-19 stuff started up. My 1-year appointment with my surgeon was cancelled--and even if it hadn't been, I really cannot afford to make a 16 hour multi-day trip to see him and ask his opinion. His office isn't so great at returning phone calls either, unfortunately. There seems to be very little research (common problem for us pouchers I think) about the pros/cons of vaginal vs. c section delivery with a J-pouch. It is my first baby, but I do plan to have more if possible, which is why I like the idea of a vaginal delivery so I can avoid creating more scar tissue. If anyone has had a vaginal delivery post-surgery, would you mind sharing your experience with me? 

I know this was a long post. I apologize. Thank you for taking the time to read/reply. 

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