I had my J-pouch surgeries at Cleveland Clinic, Cleveland, but my local Gastroenterologist and I agreed that a once-per year visit, just to keep my history up-to-date with their records in the event "something happens". He really doesn't examine me to any extent during those annuals, but takes notes on general health, pouch-related activity, diet, etc. He's also the one who keeps my prescriptions for Lomotil and loperamide going for me. He did a pouchoscopy at my 1-year pouchiversary, and we agreed that perhaps once every 5 years from then on is fine.