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I take miralax every day so usually have liquid bowel movements, when there is still stool left in I must force out,  Just wonder if anyone has been through this and have found anything to help. I eat fiber fruits vegetables etc. tried metamucil with pslium and had problems doctor claims that is too harsh. Speaking to a doctor ay NYU that God knows, might be able to help me a bit more. Between  the corona virus and this I am at my wits end. This is very hard to explain, sorry, its embarrassing for both me and you.


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I saw Dr Bo Shen years ago when he was at the Cleveleand Clinic, is he now in New York City?  Willow, the problem I now have has nothing to do with the pouch, my pouch is okay, but the muscles in my bottom have stopped working, thus making it almost impossible to move my bowels with some type of product like Miralax.  I have a video visit with a doctor from NYU who specializes in this, although I don't know if they can or for that matter anyone can help me.  I cannot  have a pouch again, at the end I became very allergic to it and was rushed to the hospital several times, it would get puss that formed where the bag was and would just fall off, one of the worst things I had to go through. Thank you so much for your advice, it is very appreciated.



I experienced extreme rectal pain when I would go to the bathroom. It was related to exerting too much force and in turn I would have muscle spasms. I wound up doing pelvic floor physical therapy. This was suggested by Dr. Shen as an alternative to having surgery, although he noted it was a long shot. However, it did provide me enough relief to continue on without surgery. You pretty much learn how to better control the muscles in that region and more effectively use them. It may be worth a shot?

What can happen is that the cuff can restrict over a period of years due to scar tissue, even more so if any pouchitis is present in the area. In the UK slight dilatation is carried out You may notice that your index finger will only just pass through the cuff, ( connective tissue between the pouch and the outlet) if that it the case then dilation may be required. I myself am struggling with a similar problem. 


I 100% agree with getting pelvic floor physical therapy.  Over the years, I’ve seen specialists in Chicago and London and am now living in Chicago again.  For me, finding a pelvic floor therapist that also has a speciality in Dry Needling was an absolute game changer.  While I don’t find it to cure me, it improves my situation greatly and I can go longer periods of time without problems.


Dry needling Is performed by physical therapists. It looks similar to acupuncture although the technique is different. It is very effective around the whole body and there are physical therapists that have a specialty of dry needling the pelvic floor. They insert the needles in your hips and butt. It is somewhat uncomfortable but gives amazing relief. They are also specialized in performing manual internal work rectally (and vaginally, for women).  The therapist can help retrain the pelvic floor to react properly.  

Hope that’s helpful. There is loads of info online too.  once you read up on it, google “pelvic floor dry needling” and your city. There aren’t tons of p/t’s that do it but it’s out there.

Good luck. 

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