Well, after suffering for almost a month with colitis like symptoms, I finally couldn't stand it anymore and went to the ER last night. I knew what I had was probably pouchitis. As usual, I got a doctor that had no idea what I was talking about, "what is pouchitis?" was the first thing he said to me. He acted like I was making the word up. I always seem to get doctors that have never heard of j-pouch surgery or anything associated with it. After 2 hours of all kinds of tests...ekg, x-ray, blood samples, urine samples, stool samples...he said all my tests were negative and I didn't need any treatment! I would think a doctor would know that a month of cramps, back pain, diarrhea and nausea would need treatment. I had to put my foot down and demand a prescription. He must have looked it up or made a call because he came back with scrips for cipro and flagyl. After one dose last night I woke up feeling good for the first time in weeks. I guess I am lucky that this is my first bout with pouchitis in 14 years. My question is now that I have had my first case and my pouch is getting 'older' will I now be more prone to getting pouchitis more frequently? I have already stocked up on probiotics!

Not really. Once you get rid of this first case of pouchitis, take your probiotics and you may never need Cipro again. Or, for a very long time.

I take Culturelle in the mornings and DanActive in the evenings. Also, I take 2 chewable Forvia vitamin-mineral tabs each day.
I have not had to take any Cipro for over a year now.

Ditto with what Bodoni says, I'm just getting over my 1st diag of pouchitis after my takedown 2 years ago. 2 weeks of Cipro knocked it down. I had been on Flora-Q for over 2 years. That alone wasn't enough to prevent the pouchitis for myself. Everyone is different though.
It's VERY IMPORTANT that you make SURE you don't have the pouchitis any more by being scoped with biopsies before you start depending on probiotics. Probiotics are not effective while on the antibiotics that you are on and are only useful while you are in remission of the pouchitis. I'm not a MD but I've been there, done that just recently. Hope this helps! Jack

The ER is probably the worst place in the world to go for pouchitis treatment. Those folks are experts in emergencies and just have general knowledge about GI stuff. Generally, symptoms that have been going on for a month are not considered an emergency. This is not to say that it is not impossible for pouchitis to become an emergency.

However, now that you know what you have, I would hope in the future, you would just wait until regular clinic hours and call your GI or surgeon. They can usually diagnose over the phone and fax a prescription to the pharmacy. This will save you from having to have a boatload of unnecessary tests. Plus, if symptoms don't improve on their own within a week, it's time to call. You are a tough cookie to wait a month!

It is fairly typical for a dramatic improvement if you get on the right treatment for pouchitis. And, it definitely does not mean you are more likely to have repeated attacks.

Jan