RYAN when you lose the colon the stomach acids take a much quicker exit route which means possibly burning episodes, I was successful with sitz baths the 1st year and actually used a lot of OTC Desinix and A&D for the burn along with cold wet or icecubes in washcloths. I slept with a waterproof pad and learned to sleep on my stomach when my system was loud & gurgling which my sleep deprived husband appreciated! lol
Over the years I realize that my pouch now seems to have more times which it might expand or bulge a bit which means it needs to release either in a BM or gas. I know the Metamucil is fiber and can cause the gas, but it also helps to pull the loose stool together for a more solid BM; and by adding Gas X Simethicone softgels (125mg) a lot of the gas symptoms seem to be in check!