Good for you that you're doing well! I love seeing posts like yours. Helps give people hope and confidence that they can still do what they want and not always stress about the pouch. I'm pretty happy at the moment with my pouch. Even with some annoying scar tissue, blockages from time to time, or the lack of a good nights sleep, I think I've been pretty lucky with the lifestyle that I've gotten back after almost not making it with severe UC. I have an amazing girlfriend, a supportive family, wonderful friends, and I'll be graduating from college in May. It definitely isn't easy all the time. We all have good and bad days, pouch or no pouch. However, I do think that it's wise to be as proactive as possible in terms of pouch health. While I say that, I realize I should probably go for a checkup soon myself. It's always good to have an idea of which vitamins or minerals you might be low on, or just to see a snapshot of how your overall health is looking.
Regarding pouchitis, I think that over time it almost becomes a natural issue that many pouchers might have to deal with. I say this because you have to realize exactly what having a JPouch means in terms of function. Our pouches are constructed from the end of the small intestines; the ileum. The cellular constituency of the small intestines are similar to the colon, but there are differences in the number of absorptive cells vs. goblet cells, etc. Also, the overall depth or muscular makeup of the two types of gut differs. The fact is that small intestinal epithelium isn't designed to perform the same type of function as the colon is, namely storage of waste and reabsorption of water & electrolytes. Over time, the JPouch does have some flexibility, and the cells will learn how to perform some of the functions that the colon normally performs. Yet you have to realize that since the types of tissue in your JPouch aren't inherently designed to function as a means of storage, over time the epithelial cells will break down down faster than those of a normal colon would.
Simply put, lets say a normal colon can function for around an average of 80-90 years in a healthy person. And let's estimate that that person poops about twice a day for his life. Assume he makes it to 90. Counting days when he might have had diarrhea or an upset stomach, the total number of bowel movements would maybe be around (2 a day)x(365 days a year)x(90 years)+(60 or so for diarrhea each year)= ~71,100 bowel movements in his lifetime.
Now let's do the same hypothetical calculation but with a Jpoucher who poops on average 6-8 times a day. If we do the low number, it would be: (6 daily)x(365 days a year)x(90 years)= 197,100! That's over double the normal person and it doesn't take into account the bad days when pouchers might go 12-20 times a day or more! 8 times a day might be more logical then and that number would be 262,800 bowel movements in a life to 90!
Now I hope the point is clear. We pouchers will go to the bathroom on average, thousands of times more than a normal person over the years! Because even normal colons themselves are only built to last for around 70-80 thousand bowel movements, it's only natural to understand that the huge number of bowel movements with a JPouch probably plays the most significant role in terms of pouch degradation or pouchitis after years of use.
Hope this makes sense? I think it's a logical explanation for why many people have problems with their pouches after 20-30 years or so of constant use.
