@Kh1988 Although some surgeons do a good job with “medical” issues related to J-pouches, gastroenterologists tend to do a better job (when they are appropriately knowledgeable about pouches). Even Botox injections would more often be done by a gastroenterologist. Perhaps there’s a local GI who can help, or (if not) who might know who to send you to at Mayo. Good luck!