Has anyone else noticed a connection between the pH of the foods they eat and a relationship to pouchitis or pouch irritations?
It's just a theory, but perhaps an imbalance in pH is causing the wrong type or not enough of the good type of bacteria to grow in our pouches. I have been killing them all off, both good and bad, with long term Cipro use and now I'm trying to eat more alkaline foods along with my probiotics to help them get reestablished. It seems to be working. I haven't been as ill lately and have been able to stay off Cipro for over a month now. Might just be a placebo effect, but it seems to be working.

Ok, what would be some examples of alkaline foods? Willing to try....
LoriP

It's easy to find such lists on the internet, for example:

http://www.energiseforlife.com/list_of_alkaline_foods.php

It's basically a vegan diet, though. I cannot understand how oranges are on the "acidic" list, but other citrus fruits (lemons, limes, grapefruit) and tomatos (but not tomato sauce!) are on the "alkaline" list. I'm not sure many j-pouchers could tolerate this kind of diet, and if they could, whether avoiding foods like dairy products, bananas, and chicken that are loaded with important nutrients that we desperately need (protein, potassium, calcium, magnesium, vitamin D, etc.) is such a great idea.

Below is a massive amount of technical information. See the section in the first link on "Acid-base chemistry in physiology" and the excellent links it provides (repeated here):

http://www.chem1.com/CQ/ionbunk.html
http://www.acid-base.com/index.php
http://www.chemistry.wustl.edu/%7Eedudev/LabTutorials/Buffer/Buffer.html
http://rnceus.com/ua/uaph.html

I think I'm out of luck with this one, I can't digest most of the alk list.
Thanks for the links anyway!
LoriP

Someone copied a magazine article about this for me once... it was hard finding a lot of further information on it. But basically it was about how to "alkaline your body". Even simply by mixing baking soda in water or another drink helped, the article said. This was after I was first diagnosed with cancer, but some of it made sense... I just didn't get enough info. There are big believers out there on the topic.

I doubt the ph of your food is relevant. There's probably a great deal more acid in your stomach than anything in your food. I could see though how eating alkaline food could neutralise the stomach acid which might increase the risk of infection.

I am confused! Do we want our guts to be Acidic or Alkaline?? My Dr perscribed Lactulose to "change the pH of my gut." I believe he said to increase the Acidity and further inhibit the growth of the yeast?? I have had chronic pouchitis/cuffitis and have been using Cipro for several years which is no longer working....anyway the dr feels I now have an overgrowth of yeast throughout my GI system. I have been on Diflucan daily for a month and will be starting the Lactulose next week. Does this make sense? Has anyone heard of this?
Thanks

LynnZee,

I may be totally wrong but it seems a bit strange to me that your doctor has prescribed it for your yeast problem. It really makes no sense to me bacause I was prescribed Lactulose as a stool softener. It's a gentle laxative and is mostly milk sugars so I can only see that as increasing your output not slowing it down. As for helping with your yeast problem I would have thought that a good natural yogurt or probiotics would be more beneficialy because I would think that the yeast would actually feed on the sugar in lactulose.

Perhaps Jan can shed some light on why he's prescribed it for you because I'm totally confused.

Hope you feel better soon.

Take care.

Shell

Here are the claims by the makers of Lactulose (a synthetic sugar not to be confused with lactose in milk):

http://www.lactulose.com/lactulose/product/0,,6837-2-0,00.htm

Given the possible side effects (cramping gas, etc), I'm not sure you want to take it:

http://en.wikipedia.org/wiki/Lactulose

The Cipro would have killed off most of your intestinal bacteria, including the ones that help control yeast. I agree with Shell that taking probiotics makes sense (can you get VSL#3?), and the Lactulose might help the good bacteria to survive.

Thanks Shell and Bobolink

I do take VSL#3-DS daily. But I have to say my Dr doesn't feel there are any benefits to taking VSL#3. He said there are no current US studies that demonstrate that probiotics work. He thinks I am wasting my money on them. However from what I read from members of this site I do think they can help. So I am taking hem and have been for about 2 months.

Bobolink the link you sent on Lactulose was helpful. Thanks. The Dr mentioned that I may NOT be able to tolerate it because of the Laxative effect. But I think he wanted me to try it for the other effects it has. (the Ammoniac binding...which acidifies the gut and promotes the growth of healthy bacteria and the pre-biotic effect which also promotes the growth of healthy bacteria.)

I am still a bit nervous about trying it though. He has me taking Diflucan for one month and I just finished 2 months of Entocort for cuffitis. I do feel much better so I am wondering if I even need to take the Lactulose?? (I was going 18x/day and had terrible anal pain and am now down to 7-8x/day and very little pain...I don't want to go backwards and start running to the bathroom due to the laxitive effect of the Lactulose!!)I think he is trying to kill of as much yeast as possible, reestablish the heathly flora and see if that keeps the pouchitis symptoms at bay??

Does any of this make sense? Has anyone else tried anything like this?
Thanks for the help. Jan any thoughts???

I'm surprised your doctor is saying that probiotics don't work as I understood there were a couple of pretty convincing trials demonstrating VSL#3 can significantly extend remission in chronic pouchitis patients. I can't comment on whether they were "US studies" or not but I don't believe that's any reason to discount them.

It's true that most of the recent journal publications about probiotics are review articles that say there's some evidence (from studies performed outside the US) that they may help in some situations, but more large, carefully controlled studies need to be done. One example in the US literature would be:

http://www.ncbi.nlm.nih.gov/pubmed/16633136?ordinalpos=...anel.Pubmed_RVDocSum

and I was searching for a while to come up with that one.

On the other hand, if your doctor does not think that probiotics work, why take Lactulose to promote "the good bacteria" (presumably in VSL#3)?

At any rate, your condition seems to be improving now, and there's no compelling reason to make changes that could result in a setback. But you could try the Lactulose in quite small dosages at first, just to see whether you get a small improvement or just more bathroom trips.

There are some other options to consider for long-term cheap pouch maintenance:

Probiotics in the form of home-made room temperature cultured yogurt are essentially free:

http://j-pouch.org/eve/forums/a/tpc/f/5951071921/m/9921...821000872#7821000872

Martiangirl has recently started taking inulin, which is a natural soluble fiber (in onions, etc.) that appears to have prebiotic effects (and downsides) that are similar to Lactulose:

http://j-pouch.org/eve/forums/a/tpc/f/9151071921/m/5411...411003082#5411003082

There are 2 controlled studies I am aware of on VSL#3. They are referred to in treatment articles Jan has posted in the past.

hi lynzee..i am in your stuation..chronoc pouchitis with cuffitis..either one or both at any time..anyway i went to cleveland clinic because everyone here in l.a area out of ideas for me..my dr. there had me on two antibiotics (because one did not work) and then add tincture of opium three drops three times a day to slow down the gut(it has got me off lomitol and fibercon)and now he too wants me to add lactolose..increase acidity which he says is good and promot good bacteria and he keeps me on canasa(forever he said)good preventative for colon cancer..was doing pretty good fot about two months and was on the antibiotics and the tincture..was just going to start the lactolose tomorrow..by the way he says in jpouchers might onl cause diarreah for two days(so i have been hesitant too) but tonight i noticed a little irritation and some blood so i think my cuffitis is actting up..

is entocort like steroid suppositories??i have some of them so i self medicated with that instead of the canasa tonight..will try that for a bit..if i get it under control i start the lactlose..since i live in sant barbara and this dr. is in cleveland i have to e-mail him whats up and he sends back response..

by the way i resorted to go here because that is where they have a pretty good data base of jpouchers and 25 percent have pouch problems!!!moreover we asked him about probiotics and he was not sure it was any good at all..at least not from the patients going through the cleveland clinic..and those studies were in italy i believe and based on small data..more studies need to be done and because we are dealing with so many variations with each person being somewhat unique who knows if it helps the chronic pouchers..i have tried it (vsl#3) and i cannot tolerate enough to make it worth the effort..

rebecca

Hi Rebe

It does sound like we have similar issues going on. I am seeing a GI at Albany Med but he told me he learned the "trick" of using lactulose from Dr Shen at CC. I tried it but didn't tolerate it very well. I send you a PM. I hope you feel better soon. It is frustrating when they can't seem to find the right combination of meds to keep things in check...hopefully we will both get there soon!