First, there is no evidence that any probiotic will lesson pouchitis.
With respect to Metamucil and loperamide, yes they can be used together but should be used at different times.
Loperamide could be used around 10 at night.
Could also double the dose of Metamucil.
Agree with seeing a dietician.
Dr. Zane Cohen M.D., F.R.C.S.(C), Senior Colorectal Surgeon, Sinai Health System