Hi,

I’m a 38yr J-poucher have the same issues that your speaking about with same results from doctors. I believe that it’s the meds that no longer work for me keeping the output at bay. 

If your output frequency suddenly increases it’s either due to building up a resistance to Imodium (or other bowel slowers) as suggested by the prior poster, or a motility issue, which is resolved by taking anti-spasmodics. If you have a motility issue it is  characterized by bursts of bowel movements right after eating a meal, regardless of what is consumed. Taking an antispasmodic pill 45 minutes resolves that issue completely. 

Otherwise if your scope is clear there is no explanation for it.

Thanks guys, I’ve never taken any Imodium or bowel slowers since the op as haven’t needed to or been on any medication (except Cipro for a confirmed bout of pouchitis a while ago). All very weird but I know that Cipro works great to alleviate my symptoms regardless of what the scopes are saying......

You may have a SIBO situation if Cipro is working well. You claim your diet is good but you don’t comment on sugar consumption. Sugar consumption could be behind SIBO and frequency. Targeting gluten and probiotics is fine but getting rid of sugar in your diet is another step you can take. Sugar is a much bigger culprit than gluten in SIBO and frequency except for those with Celiac Disease. And if you don’t have Celiac Disease gluten isn’t or shouldn’t be a huge issue.

If you haven’t tested for Celiac Disease I would also suggest that.

The suggestions above are all good ones. Definitely test for Celiac and rule out SIBO. I would add too that sometimes seemingly small things get overlooked; for example, if you have had any recent changes in diet or lifestyle, such as an increase/decrease in exercise, change in sleep schedule, change in times that you eat, etc? This can all impact pouch function. But if the scopes otherwise look fine and there is no active pouchitis or inflammation, looking at your diet is a good place to begin.  For example, you could start by reducing known culprits, like sugar.   Fried or greasy food can also have an impact on pouch function.  You could try an elimination diet - beginning with dairy/lactose - to see if that has any impact. It's very possible and in fact not uncommon to become lactose intolerant later in life, even if you weren't before. If that doesn't work, while a little tedious, you could  try keeping a food diary for a few weeks to see if there is a specific food(s) associated with increased frequency.  I've had my pouch over 11 years. In my case, I noticed a huge improvement in pouch function after I completely eliminated red meat. I've been primarily vegetarian now for 4 years, though I will occasionally eat salmon.  I'm not advocating that everyone adopt a vegetarian diet, just providing an example that identifying and eliminating potential "trigger" foods can have significant results.