This topic is about the recovery process after a loop ileostomy reversal, which is a surgery performed following rectal cancer treatment. In this case, most of the rectum was removed, and the patient is experiencing some challenges during recovery. Here are some helpful insights and advice for managing these issues:

1. It's important to be patient with your recovery. At just 4 weeks post-surgery, it's quite normal to experience significant issues. The fact that you can manage short trips outside the house is a positive sign.

2. Consider pelvic floor physical therapy. This can be incredibly beneficial in improving bowel control and reducing the risk of future adhesions through specialized scar-work.

3. Your symptoms are consistent with what is known as "low anterior resection syndrome" (LARS). This includes feelings of pressure, frequent small bowel movements, and clustering, which typically last around 6 to 8 weeks. If you have had radiation treatment, it might exacerbate these symptoms.

4. Soluble fiber supplements like Metamucil can be helpful in managing bowel movements. However, be cautious with the dosage, as taking too much can lead to other issues. It's important to monitor your body's response and adjust the dosage as needed.

Remember, recovery can take time, and it's common for continence to take anywhere from 3 to 12 months to normalize. It's understandable to be concerned about accidents and the potential need for protective garments, but with time and the right strategies, many people see significant improvement.