Frederik, like CT I generally don’t have any pouch “issues” at all. I’m a little embarrassed to admit I havn’t been scoped in years, and I haven’t had any symptom-related reasons to motivate me. There’s a bit of fussing to keep it that way (two antibiotics, psyllium, VSL #3 DS, Lomotil at bedtime, installing a bidet, emptying before going out), and some people might consider one or more of those to be a big deal, though I don’t. I’m not delighted to be on the antibiotics, but I’m tolerating them just fine, and they are worlds better than pouchitis. My breakfast and dinner prep is a little bit of a production, since I mix the VSL in yogurt, and sometimes that’s a nuisance (e.g. coordinating with others, going out to eat without going home first, traveling), but I make it work - it’s just part of my life. I try to arrange for a refrigerator when I travel, for both the VSL and the yogurt (if I’m able to buy some). I’m pretty careful to stick to these minor inconveniences within reason. Everyone is different: I tried eliminating carbs, and I found that to be a very big deal, so I was sort of glad when it seemed to make no difference for me.
CT is pushing the innocence of Xifaxan harder than I would. It can sometimes have plenty of side effects, including rash, itching, and a dreadful dermatitis. In most cases it’s very well tolerated, though. It also did nothing for my pouchitis.