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.
