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I know the typical response around these parts (except for JanDollar) is to just "live your life and not worry about it" or some similar trope, but after 10 wonderful years with the pouch, I am feeling so blessed right now to have my health after the horrors of colitis and to have a healthy pouch. but i've really been haphazard in my approach to my health. have not watched at all what i eat, etc. fortunately, it hasn't affected me. i haven't had pouchitis or anything...

i know there are no conclusive links between diet/anything and pouchitis/pouch health. but what all is out that there that is suggestive?

is the only thing really that we can do is take probiotics?
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Not sure that there is any one thing that any of us can suggest to make sure that your pouch stays healthy...we all have pouch specific tricks that work for all of us some of the time and for some of us all of the time...
No rules. Pouchers can eat and do anything and live life to the fullest without a thought to their plumbing...others need to think about what they eat or do constantly.
I tend to blend a lot of foods to keep them at a happy texture for my pouch, eat mostly natural stuff, very little 'store bought, pre packaged foods' and live a reasonably healthy life style.
None of that has stopped my pouch from having the occasional bout of pouchitits, blockages and an assortment of little and big problems.
Most times it is fine but some times I want to kill it...
I do take vitamin suppliments and try to clear out my pouch completely at least once a day (lots of fluids, no solids in the mornings until my pouch is totally cleaned out)some people swear by it...I think that it helps to not develop pouchitis. (no medical confirmation here).
I just hope that you have a problem-free pouch life.
I am only 8 months post take down and I intend to live my life enjoying the foods I like and as drug free as possible.

It is not entirely without problems.. but none of the problems are insurmountable. For me (and only me) I think a positive attitude is key. I do take align once a day and my neurontin
(for my previous neurological issues.)
I too am one of those J-Pouchers who's just enjoying the ride and enjoying life & trying not to worry about it. Like you, I have had a very easy time since my take-down. I eat whatever I want-for the most part-some foods like really spicy stuff I know I will pay the price for in the form of butt-burn but I still eat it. I have had little to no issues but like you I also worry that may be I should be more careful and proactive in an effort to protect what a blessing I have. I take 1 Phillips Colon Health probiotic daily (before bed) and that's it. Just had my bloodwork done & doc said I'm a little low on Vitamin D so I will start to supplement D & Calcium (they seem to go together). Googled Vitamin D deficiency and was surprised to read that there is a relationship between intestinal surgery & deficiencies. Now it's been 4 years since my take-down & this is the 1st time I've been told anything was "out of whack" so I'm not saying there's a direct correlation but it got me thinking that I probably should be supplementing whatever it is that was absorbed by my colon.
Good for you that you're doing well! I love seeing posts like yours. Helps give people hope and confidence that they can still do what they want and not always stress about the pouch. I'm pretty happy at the moment with my pouch. Even with some annoying scar tissue, blockages from time to time, or the lack of a good nights sleep, I think I've been pretty lucky with the lifestyle that I've gotten back after almost not making it with severe UC. I have an amazing girlfriend, a supportive family, wonderful friends, and I'll be graduating from college in May. It definitely isn't easy all the time. We all have good and bad days, pouch or no pouch. However, I do think that it's wise to be as proactive as possible in terms of pouch health. While I say that, I realize I should probably go for a checkup soon myself. It's always good to have an idea of which vitamins or minerals you might be low on, or just to see a snapshot of how your overall health is looking.

Regarding pouchitis, I think that over time it almost becomes a natural issue that many pouchers might have to deal with. I say this because you have to realize exactly what having a JPouch means in terms of function. Our pouches are constructed from the end of the small intestines; the ileum. The cellular constituency of the small intestines are similar to the colon, but there are differences in the number of absorptive cells vs. goblet cells, etc. Also, the overall depth or muscular makeup of the two types of gut differs. The fact is that small intestinal epithelium isn't designed to perform the same type of function as the colon is, namely storage of waste and reabsorption of water & electrolytes. Over time, the JPouch does have some flexibility, and the cells will learn how to perform some of the functions that the colon normally performs. Yet you have to realize that since the types of tissue in your JPouch aren't inherently designed to function as a means of storage, over time the epithelial cells will break down down faster than those of a normal colon would.

Simply put, lets say a normal colon can function for around an average of 80-90 years in a healthy person. And let's estimate that that person poops about twice a day for his life. Assume he makes it to 90. Counting days when he might have had diarrhea or an upset stomach, the total number of bowel movements would maybe be around (2 a day)x(365 days a year)x(90 years)+(60 or so for diarrhea each year)= ~71,100 bowel movements in his lifetime.

Now let's do the same hypothetical calculation but with a Jpoucher who poops on average 6-8 times a day. If we do the low number, it would be: (6 daily)x(365 days a year)x(90 years)= 197,100! That's over double the normal person and it doesn't take into account the bad days when pouchers might go 12-20 times a day or more! 8 times a day might be more logical then and that number would be 262,800 bowel movements in a life to 90!

Now I hope the point is clear. We pouchers will go to the bathroom on average, thousands of times more than a normal person over the years! Because even normal colons themselves are only built to last for around 70-80 thousand bowel movements, it's only natural to understand that the huge number of bowel movements with a JPouch probably plays the most significant role in terms of pouch degradation or pouchitis after years of use.

Hope this makes sense? I think it's a logical explanation for why many people have problems with their pouches after 20-30 years or so of constant use.
I'm not convinced that pouches (or colons) have a service life measured in numbers of bowel movements. Certainly the ileum isn't perfectly designed for the storage of stool or absorption of water, though it does get more colon-like in J-pouchers. Most folks with J-pouches do just fine; some of the problems are structural, when a pouch isn't built optimally, and some may be due to stool sitting around in the "wrong" place. We'll probably find out in the future that an out-of-balance microbiome is a big part of what causes some problems, but that's still a bit of a medical mystery.

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