This doesn’t sound like pouchitis to me. Have you noticed being more gassy during/after the distention episodes? If it’s gas we can talk about things to try to reduce that (e.g. Beano, SIBO treatment, etc.). Another possibility is frequent partial obstructions, which fits with the distention and discomfort. Obstructions can be tricky, but you might get relief from switching to a liquid-only diet at the first sign of trouble. You can also try increasing your water intake in general, which can (for some folks) prevent the problem. Increasing fluid is particularly helpful if this is more constipation than obstruction (i.e. the stool is a bit too thick, rather than the intestinal passage is slightly narrowed).

Some of the things you’re taking could be contributing to the problem. You could try skipping the loperamide for a few weeks to see if the pattern changes. You could similarly try skipping the supplements for a few weeks, except perhaps the vitamin D. I take a lot of VSL, but I wouldn’t if I didn’t have a pouchitis problem.

It’s best to change one thing at a time in most cases, so you can honestly interpret the results if things improve. Good luck!

I have had a distended abdomen for about 11 years now. Everything is fine with me, I have been checked out many times and there is no known cause with it for me personally.

I would suggest getting checked out if you are worried about it.

Keep us updated and Happy New Year Dear