I had my j-pouch placed due to FAP. Been ileostomy free since 6/2021. However it has not been a smooth ride for me either. I have horrific hot shards of glass sensations with spams and sharp pain with bowel movements and incontinence with severe spasms. Have had chronic pouchitis which I have been on cipro, flagyl, prednisone, cefdinir ( that work on first cycle but not when repeated). I have a bidet, I use fiber capsules, I did pelvic floor PT for tight sphincter and still use vibrating wand at home every other day. I got put on a compound suppository (181.5 mg gabapentin, 91 mg diclofenac, 60.5 mg baclofen and 60.5 mg cyclobenzaprine) twice a day and it helped greatly initially. I use vibrating device and or ice pack between buttocks to help break pain cycle of the burn. I shouldn’t have to grip the door jam and the toilet seat just to have a BM. Nights and early am are my worst. I also take lomotil 2 tabs 2x/day, lyrica 100 mg 2x/day, nortriptyline 2 at bedtime, a lidocaine ointment 2x a day, Bentyl 2xday. I even tried GABA. Maybe some of this will help you Heather. I feel your pain- literally.Looking for a new GI doctor that thinks out of the box & specializes in pouchitis/tenesmus/ proctalgia fugax). I live near Wilmington NC, but will travel anywhere at this point. My original surgery was done in Florida at Cleveland Clinic- not a great experience so don’t want to go back there.