For me it's pretty obvious when I get pouchitis because I get symptoms that I don't have any other times. I think I've had it three times now since getting my J pouch. The other two times I've managed it myself but this time was really extreme. So for me one of the first symptoms I start getting is chronic headaches and migraines because I am particularly prone to this and when I get any kind of inflammation in my body that's one of the first areas to be affected. Then I start to have absolutely chronic diarrhoea and a kind of griping sensation in the j pouch. For me the really big and horrible effect is that the diarrhoea becomes so bad I become incontinent overnight. I don't have this problem at any other time. I start to get a bit feverish and exhausted obviously because everything I eat goes straight through me. I really have to be very mindful of hydration.
I have use a lot of the protocols that Jini suggests and have a great success so far. I have a very strong feeling that mine is linked to an Overgrowth of Candida. I have that annoying habit that when I am doing very well I start sneaking into my diet things that I really shouldn't be having like coffee, alcohol and more sweets than I need.
This recent bouts of pouchitis have been a really strong reminder that I need to be vigilant with my diet all of the time if I want to have good health. I can't stand the idea of having chronic pouchitis. Some people are willing to have this and take a preventative drug like flagel but I would rather be off the drugs. That does not sound like a good scenario to me.