I say this because while jpouch success is good, ileostomy success is... definite. I am taking 8x immodium, metamucil/questran sometimes (I don't think it does much for me), VSL#3DS, using a bidet, wet wipes, calmoseptine ointment, Balneol for the anal canal, HC suppositories (while my cuffitis appears to have been mostly diversionary, maybe not all of it was), and the occasional painkiller/sleep med. I am highly proactive in doing my best with pouch symptoms (I'd go crazy if I didn't).
Don't idealize ileostomies, though -- there are a lot of risks associated with permanent ileostomies that j-pouchers avoid or minimize. For example, the risk of bowel obstruction is much lower with a j-pouch than with an ileostomy. So is the risk of prolapse and hernia. Not that it's important for you, but fertility is much better in women with j-pouches than women with permanent ileostomies. The list goes on -- there are definitely problems associated with ileo QOL, we just tend not to hear about
them because they usually emerge after years and years, and not many UC patients keep ileostomies for that long anymore.
I would want to wring my neck if I gave myself this advice, but I'll just throw it out there... you're using a lot of different things right now, probably so many that you introduced multiple treatments at the same time and would have no way of knowing if something is making you feel worse. I can tell you with certainty that my pouch cannot tolerate Metamucil or VSL. I experimented with both of them in attempts to "fine tune" my pouch that was already behaving pretty well, and they made me feel much worse. You might consider rotating *out* one thing at a time and see what happens.