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I have read on here that it is bad to push and strain while trying to have a BM with a j pouch. Why is this? I was just curious because when in a public restroom a lot of the time you can hear the guy in the stall next to you grunting like he is lifting weights. Of course I relise the risk of hernias and damage right after surgery would be a good reason not to strain but once things are healed up what damage does pushing a little harder do? What would be the difference in straining if u had a colon or are colonless? Just trying to gain a little knowledge since I am so new to my new body and this lifestyle. Smiler
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I believe it's because you can't cause a prolapse. CeCe - one of the members here - produces a hard cough at the end of evacuation and that helps all the little bits exit. Once you're past hernia producing time you could try that to see if it helps.

Pushing 'a little harder' shouldn't do much damage.... unless it does. In other words, one never knows what or if something will cause a problem. I don't have any problems with straining with my 22-year old pouch - it still works just fine.

kathy Big Grin
To explain further, even though your pouch is made of small intestine that has been in your body your whole life, it is put to a use it was not designed for. The rectum has a lot of muscle tissue in it that contracts when you have a bowel movement and provides support. The ileum does not. Straining with a rectum can cause problems too, like hemorrhoids, fissures, rectal prolapse, even a stroke (many strokes occur during a bowel movement).

However, with the ileal pouch, in addition to the above, severe straining can cause prolapse severe enough to cause internal collapse, or even extrusion of the pouch through the anus. This can lead to very serious emptying problems, often requiring surgical repair.

So, best not to strain.

Jan Smiler

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