I just wanted to find out if this is normal. I've had my J pouch since 2012. Ever since, I've always had to strain pretty hard to empty completely. I especially have a difficult time passing gas. Gas, especially, takes forever to come out and I have to push extremely hard to fart. In the beginning, a lot of the time, when I felt like I had to fart, I wasn't even really sure if I really did or if I was just imagining it, because it was such a vague small amount of sensation I feel, when I do. But then I fart and the feeling goes away, so I learned over time that's what it actually does mean.

I don't believe I have pouchitis. I'm not going to the bathroom an excessive amount of times and I don't have any urgency. So I don't think that's the issue at all.

I've noticed that other people on here say that it helps to keep your stool thin if you have this problem, but I don't understand that. For me having thin stool makes the straining much worse. I find that if I take about two glasses of Metamucil a day, that makes my poop more solid, which helps tremendously. It makes it so that instead of having to sit on the toilet for a half hour and have a bunch of small poops, I can just have one big one instead and be out of the bathroom in under 30 seconds.

It's like the stool being more solid gives the sphincter muscle something to grip onto - like the difference between picking up water with your fingers vs. picking up an ice cube. I think this is caused by the fact that the small bowel just doesn't have the same kind of muscle actions that the colon does, to propel the poop forward, so you have to rely on gravity and your spinchter and abdominal muscles instead.

Is this normal? Do other people relate to anything I said? Do I need to see my surgeon about this issue? I'm concerned that all this straining could cause a stroke or burst eye blood vessel when I get older. Or other medical problems that are caused by pressure from straining to much. 


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