Yes, Dr. Shen wrote a very comprehensive article. I have read many of his articles, and by other authors too. A recurring theme has always been that chronic pouchitis is quite complex, with many etiologies, disease courses, and treatments. There is no one "rule book" to follow, other than whatever works for you. This is why sharing ideas is good for coming up with new options to try, but by no means any sort of assurance of effectiveness.
It has long been known that pouchitis is primarily associated with IBD (I remember reading about it after my surgery in 1995). This is why it is felt that chronic pouchitis may be a new form of IBD. Those without IBD do get pouchitis, but it is usually related to NSAID use, infection, or bacterial overgrowth. To complicate things further, those with IBD are also subject to those issues too.
My mind wanders to the concept of "herding cats" to describe the challenge of treating chronic pouchitis. Soon as you think you've got it figured out, all Hell breaks loose!
Jan
