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Jpouch HELP!
 
Sorry for a lot of the questions but i just need to ease my mind a little. Im 19, 5 days post takedown and today is my first day home. Is what im experiencing normal for someone with a brand new jpouch?
 
1. I can randomly be sitting and have the urgency to go, I can hold it in but sometimes i go to the washroom. Nothing comes out
 
2. I experience tenesmus all day. Its the feeling of something being stuck and not coming out and is a symptom i had when i had UC and when i had my ostomy it was gone.
 
3. My rectal muscles involuntary strain whenever i get one of the urgencies to go and sit. I can kinda stop it if i stand up but if i sit down it comes back.
 
I have a bidet and use calmoseptine after i go to the washroom every time.
 
are these normal things to experience??
 
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For maybe a couple of days after my takedown, whilst still in hospital, I experienced similar to what you've described.

I had a sensation to pass what felt like a golf ball, excruciatingly painful with similar but controlled urgency as yourself but once on the toilet, nothing would come out.

The sensation probably only lasted maybe 24hrs, possible because I began to apply ilex paste just to the inside of the anal sphincter, which provided instant relief.

Some weeks of maybe months later, I discovered that during my takedown surgery, what remains of my anal canal was dilated and this stretching procedure can cause tearing within, so I believe the sensation and excruciating pain was cause by anal fisures,

Maybe what you're experiencing is the same?

Last edited by Former Member

Hi Daniel, I experienced the same after my takedown. For me, it felt like I had a burning rock wedged up my butt for weeks, which made tenesmus constant. After weeks of this, I thought I would go insane. The only relief was to take several sitz baths a day and a Percocet. The tenesmus/pain will eventually subside, but here's some advice that I learned the hard way: don't let the involuntary straining continue! Stand up and stop the spasm, and then walk away if nothing is coming out. Otherwise you might have increased pain and burning for days until the swelling goes down. In hindsight, I think the spasms and auto-straining to "get it out" created more  inflammation, more swelling (which causes the sphincters to tighten), and therefore it became even more difficult to empty, and I would have increased bms. It's a vicious cycle. The good news for you is that you're young and should bounce back, just hang in there and keep asking questions!

Jfill21 posted:

Hi Daniel, I experienced the same after my takedown. For me, it felt like I had a burning rock wedged up my butt for weeks, which made tenesmus constant. After weeks of this, I thought I would go insane. The only relief was to take several sitz baths a day and a Percocet. The tenesmus/pain will eventually subside, but here's some advice that I learned the hard way: don't let the involuntary straining continue! Stand up and stop the spasm, and then walk away if nothing is coming out. Otherwise you might have increased pain and burning for days until the swelling goes down. In hindsight, I think the spasms and auto-straining to "get it out" created more  inflammation, more swelling (which causes the sphincters to tighten), and therefore it became even more difficult to empty, and I would have increased bms. It's a vicious cycle. The good news for you is that you're young and should bounce back, just hang in there and keep asking questions!

Thank you so much. Thats what i have been doing. this is usually how it goes. I sit, poop comes out literally the moment i sit because i felt the urgency, when the poop comes out the straining happens as if i had more poop to push out. I stand. I take a minute break. I sit again it repeats.

I also go to the washroom a lot. I bought metamucil and immodium which thickened my stool but i still go often because i dont fully empty it every single time because a) im not sure how and b) the straining is in the way because the poop comes in waves

Yeah, sounds so familiar. I finally went back to my surgeon (about 3 months post takedown) because I felt I should be farther along. She scoped me, said the pouch looked great but there was some inflammation in the anal transition zone (cuff) but that was normal. She then ordered a manometry exam. The diagnosis from that test was that my pelvic floor muscles were working against each other, rather than relaxing and “opening up.” You know, the old way we used to poop was via muscular contractions. Now it’s mostly gravity and if you push or strain, you don’t have more poop coming out, you’re actually preventing poop from expelling. I was referred to a pelvic floor physical therapist and I’m still doing the exercises and stretches. As everyone on this board says, “give it time—it gets better.”

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