KennyJ, I can relate to your symptoms. My pouch is almost 5 years old and I’ve had emptying issues ever since. I finally went back to Cleveland Clinic this spring and had a pouchoscopy, plus defecography and manometry tests. The pouchoscopy showed mild inflammation and “anal congestion.” It was not surprising that my manometry test showed a sphincter squeeze score 3X higher than “normal.” The theory is that I probably over developed the sphincters by clenching continuously to prevent a mucus accident after Step 1 (of 3). I was referred back to pelvic floor physical therapy.