I am going to go out on a limb here! I think everyone who thinks they have Chronic Pouchitis should be tested for SIBO. It may save you a lot of aggravation!

I have been suffering with what I thought was chronic pouchitis for 23 years.  I had my pouch built in 1993.  From day 1...maybe day 2, I have had excess gas & pressure.....just miserable! Well, that is what my surgeon & GI told me.  So the answer was 22 years of anti-biotics...Cipro, Flagyl, Biaxin, etc...etc.  Scope after scope showed inflammation in there. But even while taking the AB's, I would sometimes still have gas & pressure. I always figured that the AB's were loosing their effectiveness.  I came close to having my pouch removed 3 times out of desperation.     

In 2014, I started to read about SIBO (small intestine bacterial overgrowth), and the more I read, the more I knew I had it. I asked my GI to test me, and sure enough, I have SIBO!  

The diet that was recommended to me was the FODMAPS diet, and I have been doing it for about 10 months now.  I do not take antibiotic anymore! It works because it eliminates the food that I cannot digest.  These undigested foods end up fermenting in the gut which in turn cause gas & pressure.  It is a diet that is very hard to follow, and I cheat daily.....which would result in me having some gas & pressure. But a whole lot better than before. 

While reading up on SIBO, I found out that peppermint oil is good for digestion.  I have been supplementing with peppermint oil.....5 drops in water everyday.  That has taken all the gas away, and I can now cheat intermittently & eat some "no-no" FODMAPs without any getting excess gas & pressure.  

I also take a probiotic everyday.

I wanted to pass this along in hopes that you don't suffer like me for 22 years!

Joe