I don't know what to do

Hi all. I'm 3 months past my reversal/takedown and having a much harder time than I expected. My colorectal surgeon has basically told me he doesn't know how to help me anymore and I should seek the insight of a GI. I was able to get in to see an IBD GI, albeit not a jpouch expert, so seeking the insight of the community here.

Main Issues I’m having :

  • Intensely painful cramping (currently managed with antispasmodics and muscle relaxants)
  • Deep fatigue and brain fog (I think because of the meds)
  • Difficulty passing gas or stool (stool is Bristol 4/5, sometimes 6, snakey, semi-solid)
  • Spending hours on the toilet in the evening before I feel like I am "done" (but there's always more; I usually have to get up b/c I'm too tired to sit there any longer)
  • I've tried to get off of antibiotics 3 times but each time has to get back on them due to return of intensely painful cramps

GI’s plan and reasoning

  • Reduce loperamide, stay on antibiotics (reduce loperamide because it my be slowing transit, causing cramping)
  • ⁠Nifedipine ointment to relax anal muscle, consider LIS for fissure (I had a botox injection after a chronic fissure reopened post surgery)
  • ⁠Flex sigmoidoscopy to see if there are structural problems (adhesions, strictures, etc), inflammation (cuffitis), infection (pouchitis)
  • Small bowel MRI to check for inflammation, structural problems
  • Taper down antibiotics one at a time

In particular, I’d like to get your thoughts on getting a flex sig scope just 3 months after my takedown surgery. It seems too soon. Colonoscopies have been very hard on me in the past (including an episode of suspected bacteremia) and I am wary about doing prep. This will be my first experience with prep with a jpouch, on top of everything else I’m experiencing, so I’m very wary.

(Marking the below as a spoiler so as not to bias anyone before; take a look after forming your opinion, maybe)

I’m also concerned that this GI doesn’t have a ton of experience with j pouches. My wife and I weren’t entirely comfortable with him or confident in his assessment as it seemed apparent that he didn't have a ton of experience with jpouchers. Frankly, I don’t know where to turn to find that insight. Jpouchers are a sub-population of a sub-population, so of course there isn’t widespread familiarity with, or expertise in, treating people with pouches, much less those who experience complications, so I’m feeling quite vulnerable.