I also do not understand when you say Crohn's in the pouch is a "big difference" from chronic pouchitis. It isn't. Both are treated the same. Both are species of chronic inflammation and cannot be allowed to go untreated. If you think chronic pouchitis left untreated cannot lead to something bad happening, you would be badly mistaken. The Cleveland Clinic study on rectal cuff cancer patients showed that many had severe pouchitis, some cases of which had not been properly treated.