I had my j-pouch done at the age of 16 (first surgery December 2006, reversal in March 2007) and I am now 28.  I've thankfully never had any issues with my pouch until now, except for the occasional discomfort/gas issues because of something I ate.

I also stupidly never went for a colonoscopy (or "pouchoscopy") or follow up visit until 2015, 8 years after surgery.  I was told everything was fine though.  I went again this past September, again, everything was fine.

However, the past week or so I've had terrible constipation.  The feeling like I have to go, but I have to push extremely hard and very little stool passes through.  I've been pushing and wiping so much, that there is blood on the toilet paper.  I've been using a lot of A&D ointment too.  Not to be TMI, but I've slathered q-tips in A&D ointment and shoved them "up there" to relieve the irritation and have noticed a little blood on the q-tips too.

Last week, I took Linzess that my doctor prescribed me.  That usually makes me go anytime I feel constipated and cleans me right out.  Well the Linzess worked a little, but not like it normally does.  I still feel like something is not coming out.  Almost as if I have a blockage...my stomach is very bloated and I'm extremely uncomfortable, and I am now having a pressure-like pain around my anus too. 

I've also felt a bit tired/weak the last few weeks, though not sure if that is related.  Not to mention I was taking the weight loss drug Saxenda, which caused constipation as a side effect while I was on it, but it was never this severe and I stopped taking that over 2 weeks ago.

I am going to my doctor tomorrow, but just wanted to see if anyone here had any thoughts on what this could be.

Original Post

There are a few possibilities, but it’s probably not pouchitis. It’s important to try not to push very hard - it can make some problems worse (like pouch prolapse and hemorrhoids), and it can add problems to whatever you already have going on.

Let us know what the doctor says.

Yeah please stop pushing so hard even if nothing is coming out. I had once very little blood come out when I had pushed too hard, my surgeon strictly asked me to never repeat it. 

Somethings you can do at home to cure constipation is take a light laxative like black coffee, pysillium husk with a glass of milk ( believe me this one is the best ). Relax your butt everytime you sit on the seat let the pressure to go build up without trying to push. I sometime sit in weird yoga poses to get evrything out without having to push. Take deep breaths everytime you think you have to push.

I hope you find these a little helpful.


Yes I had a problem like that now I 68 years old and had my pouch since 2011 I had protrate problems I went to the  ER and found I couldn't pee in a cup because of the prostrate wouldn't open with all that fluid in my bladder wighted down on the J pouch cause that problem of a simulated constapation now I was put on flow maxs and it helped with Cipro then found out that we with J Pouch are more prone to pass kiney stores after I pass one earlier this year  and a short time later I begain to fill the toltoi with blood this lasted for 24 hours and went away I think they proscrbed morfren and  I had a reaction to the pain meds from ER I have a scope coming up on May 9 with the stomach check as will 

Pouchoscopy went well. Doctor said no strictures, and he isn’t quite sure why I was having issues. He gave me Canasa suppositories for 30 days and told me to go back to see him when I’m done with them. Took a tissue biopsy just to be safe. Weird. Symptoms have gotten better though, and actually started improving the day before my procedure.

My best guess is that this has to do something with the weight loss drug you were on. I had severe constipation when I was on Cipro. It was exactly how you described. Key point - i stopped it right away after a week course and it still took me two weeks after to get anywhere close to normal.

i still have constipation time to time and my go to has been prune juice. Any other suggestions would be highly appreciated...

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