Now that I’m on a good probiotic the bacteria in my system and pouch stays calm and rarely flares. I’m 15 years out too. I find those of us with jpouchs have sensitive digestive tracks and often find the foods we eat are key to keeping things calm as well. I still get iron once a year. Dairy and beef are too hard to breakdown and flare my system along with bloating and pain. I hope this help you in some way.