Scott, It took a bit of searching, but I found this passage in the article “Pouchitis: What Every Gastroenterologist Needs to Know” (under the section Prospective View and Recommendations).
https://www.ncbi.nlm.nih.gov/pubmed/23602818
”Patients with minimal symptoms but with endoscopic inflammation still should be treated to minimize smoldering inflammation causing chronic “stiff” pouch with transmural inflammation, which can result in pouch failure.”
While it seems like speculation, it is known that a chronic “stiff” pouch can become an unusable and failed pouch. There is no return from a failed pouch.
Jan