It's very true that j-pouch surgery is still relatively rare, so that is why it's understandable that many in the health profession haven't come across it first hand. Any time I have to see a new doctor, I go fully expecting to have to give somewhat of an explanation. Occasionally I'm surprised (my Gyn was quite well informed about j-pouches and I was very much impressed with what she asked and how she handled me). But I think the general beef (at least for me anyway) is with the doctors we see regularly who still, years later, haven't made an effort to grasp what having a pouch entails. That is what I find most frustrating, and I think others would agree as well.