BM help needed!

I've used psyllium since the day I got home from the hospital, and it's worked well for me. Metamucil or Konsyl should incorporate more water into the stool and help prevent making the fissure worse. I use a 50/50 mixture of Metamucil and Konsyl with breakfast and dinner. I'm not sure a tsp is enough, though I wouldn't exceed the labeled dose. It's okay to experiment!

Psyllium also helps bulk up liquid stools. It's not magic, or even complicated, it just makes everything closer to the gel consistency of psyllium plus water plus time.

For the painful itch, get a bidet attachment for your toilet, or even a bidet squeeze able bottle with nozzle. Use the hottest water you can tolerate to clean the area thoroughly each and every time. Dry carefully and apply barrier cream. I used to use Calmoseptime for weeks after takedown until it started to irritate my skin a bit (it contains small amount of menthol). Now I use Zincofax, the same cream used for baby bottoms. Very gentle, and for me it heals sore skin in one day. But the bidet is most important. I carry unscented wet wipes when I am away from home to avoid using dreaded toilet paper found in public bathrooms. And I have discovered that sourdough bread thickens output. I eat this every morning with peanut butter and soft cooked egg. I don't know what it is about the sourdough. Maybe there is an element of probiotic?  

A bowl of oatmeal does the trick for me.  If/when I feel the need for some help a bowl of oatmeal makes it easier to pass BMs.  If I want really fast results I eat a Granny Smith apple....skin and all.  Keep hydrated!  Use a barrier cream and make sure your back end is really clean before you apply the cream.  I, too, have a bidet and it is the best thing I invested in after my takedown.  I've had it almost 15 years!  Best wishes!

On the upside, 5-6 BMs only a few weeks post takedown is fantastic. Many pouchers do not ever reach that low in frequency. However on the flipside, thick stool and straining to pass BMs is not fantastic, and definitely something you want to avoid. Even now, at almost 9 years post takedown, I prefer my stool to be slightly looser as they are easier to pass. Your stool consistency may naturally improve over time as your body continues to adjust, but in the meantime there are things you can do to help. 

The suggestions provided above for loosening the stool are great. I would add a few more -

1. Check your fluid intake. You may not be drinking enough, and this can result in thicker, drier stool.  If your are urinating infrequently or if the urine is very dark yellow or thick, that's also a definite sign to up your hydration. Doing so many in turn help with stool consistency.

2. Prune juice or grape juice. Drinking small amounts every hour or so throughout the day may help loosen the stool.

3. Coffee. Seriously.

4. Magnesium supplements, especially magnesium citrate, can loosen stool.  It turns out that a good number of people who have UC are also magnesium deficient anyway, so supplementation can have a twofold benefit. However be careful as mag can also cause the opposite effect - you may end up with diarrhea. If you choose mag supplementation, you may want to start with 50 mg and adjust from there.

As for your itching, you can try a barrier cream such as Calmoseptine. I love the stuff and still use it. A nurse once also suggested to me to clean with a bit of witch hazel after each BM. You just need a little bit on the toilet paper or you may get an unwanted burn, but it does help over the long term. That being said, persistent itching that does not improve with conservative methods (like barrier creams) may be a sign of a yeast infection. If the itching does not improve, that is something you will need to rule out.

Thanks everyone for the tips! I've been taking fiber at breakfast and dinner and that has helped. I got me some decaf coffee too. I just have to find the right balance!