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Hey guys, I was wondering if some of you experience similar problems.

Mostly at night or long periods without emptying the pouch (5-7 hours) my pouch gets itchy and I feel the urge to empty it. At nights I wake up with the urge to empty it. When I do, there's not much coming out. It's not gassy, just itchy, it feels like it is at the very bottom and just an inch from coming out. (I am sorry for my poor english)

Do you have any experience with that? Is it something I need to get used to or are there things I can do to change that?
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Just a little clarification on Scott's post. If your pouch shows no evidence of pouchitis on scoping, you don't have pouchitis. However, you may still have bacterial overgrowth, which is also treated with antibiotics. If you have pouchitis symptoms that do not respond to antibiotics, it is likely IPS (irritable pouch syndrome). Then the treatment is the same as IBS.

Jan Smiler
I am quite certain that I do not have a pouchitis (I had pouchitis 2-3 times after I got my pouch which was in August '13).
It actually got better to this day...

About that bacterial overgrowth. I am currently on probiotics (Mutaflor), are probiotics also responsible for a (negative) overgrowth?
As far as I know the bacterial species responsible for SIBO (small intestinal bacterial overgrowth) are not the same as the species found in various probiotics. I certainly wasn't advised to curtail my (prescription) probiotics while I was treated for SIBO (with doxycycline). Also, pouchitis is a set of conditions that can present differently at different times.

The gut microbiome is profoundly complicated, and we understand such a tiny fraction of that complexity that we shouldn't be overly confident about any of it. The J-pouch microbiome won't be understood for many years after the colon microbiome is figured out, since there are relatively few J-pouchers. "This seems to work" is the best we can do at this point. The notion of "good bacteria" and "bad bacteria" (other than parasites like C diff) is almost certainly incorrect (or at least mostly incorrect), though it may help us get more comfortable with our nostrums than the more primitive-sounding "this seems to work."

My advice is to try things that seem to work for others, and to pay close, patient attention to what works for you. Your microbiome is probably quite different from that of others.

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