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I don't have any of that!!!!!!! The gas starts around 5 or 6 hours after I eat, and if I expel it I'll go in my pants. So I run to the bathroom and try to go, sometimes I can and sometimes I can't. It's back and forth for at least 3 to 4 hours. My anus is so sore from pushing it's not funny.  When I'm finally able pass the stool the gas goes away and I'm finally able to go to sleep. What does this sound like to you??

Those 5 to 6 hours are the normal time for food to pass the stomach and the small intestine. It sounds like there is some kind of narrowing if it is so difficult for you to pass the stool. Is there increased pressure at the outlet or a feeling of inflammation - or does the pouch feel empty are you are just feeling bloated?

Is your stool soft or rather firm (which may cause a partial blockage)? For the latter psyllium husk with a glass of water during a meal would be an option.

When was your last scope? Was something like a stricture at the pouch inlet or outlet ever mentioned? It's difficult to guess with so little details.

You’re describing, I think, two different but related things: 1) excessive gas production, and 2) difficulty emptying your pouch. Difficulty emptying is bad enough, but excess gas makes it considerably worse.

Excess gas can be caused by a variety of things. Common sources include swallowed air, carbonated drinks, gassy foods, and SIBO. The easiest first step is to eliminate or mitigate the first three of these, and if that doesn’t do the trick then a doctor’s visit to discuss SIBO diagnosis & treatment is a good idea.

Difficulty emptying can be a very tricky problem. Frequent toilet trips with straining are common when this happens, and I think they make the problem worse by enlarging hemorrhoids, irritating the anal canal, and sometimes causing pouch prolapse. If there is no firm/hard stool that might be causing this then it becomes a medical question: maybe there’s a stricture, maybe the anal sphincter is too tight, maybe there’s pelvic floor dysfunction (not the same as pelvic floor weakness), and perhaps the pouch is prolapsed. Some people report this symptom with pouchitis, and that’s among the easiest to diagnose and treat.

I hope you can find a doctor competent to help you with this!

Last edited by Scott F

Thanks, Scott, What I question is why am I okay during the day??? I'm not fine, but I don't have this running back and forth to relieve myself. My pouch has never been perfect, and I've been on Cipro forever, but this is getting really hard to live with. What is pelvic floor dysfunction and how does it differ from a weak pelvic floor?

Mema, I’d guess that the timing is related to your eating and drinking habits, but it’s hard to know for sure. After I was on Cipro alone for about 8 years it slowly lost effectiveness - this crept up on me over many months, so gradually that I didn’t notice the changes. In my case adding Flagyl did the trick and got me back to a good situation.

Pelvic floor dysfunction is when the muscles don’t work together properly, with some relaxing as others contract, so instead of easily letting the stool pass out of the pouch easily it gets blocked by inappropriately contracted muscles. Pelvic floor physical therapy can help with this, if it’s the actual problem. I’d guess it isn’t your problem if you’re pooping fine during the day.

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