I have had my pouch since 2013 and I have had cuffitis frequently but now looking at pouchitis as the last three weeks things have gotten worse. I also had a surgery went badly for a fistula, they sewed a flap of skin inside the rectum a few months back, so I am not positive if I have developed chronic pouchitis or having issues with the cuffitis or fistula surgery yet, but what my girlfriend who is a J-poucher said, is that she had every symptom I suffer with and remecade has saved her life in terms of the pain? The metronidazole only works for so long before your body becomes immune to it is what I am told. Good luck with your pouch .... glad you've gotten 30 years out of it!