I have been fighting pouchitis for about a year and my family Doc. would put me on a 10-day regimen of Flagyl and a week after that it would come back.

Today I finally got to see a G.I. and he said that I needed to stay on the medication for at least 6 weeks. He gave me a script for that.

Then he gave me 4 boxes of VSL #3 and told me to take two a day every day.

My question is: I read here or somewhere that you shouldn't mix VSL with antibiotics.

Is that true or not?

Thanks,

Ron

Yes and no. If you take them at the same time you definitely will be wasting one or the other or both. Some sources say that you should wait until you are done with your antibiotics before starting probiotics because of the biologic competition. Others say that it is not only fine, but recommended, to prevent overgrowth of yeasts. The probiotics should be at least 2 hours before or 4 hours after the antibiotics.

So, if you do take them concurrently, make sure to space them out as much as you can and do not take them at the same time.

Jan

I take PB8 and DanActive in the mornings and take a combo of Augmentin & Cipro at night. I seem to be doing very well lately on it, so I'm a bit leery about changing things up and experimenting.

With pouchitis, it's my belief that once you find something that works, you STAY ON IT and don't stray too far.

I'd like to think my probiotics are helping me, as I'm down to 3-5 BMs a day, no urgency, plenty of control. But I'm not about to change anything to prove their efficacy.

Dan

Hi EZ Money, I just got back from the Cleveland Clinic a few days ago and am in the simular situation as you are. Last week my local surg in my hometown diagnosised me with cronic pouchitis after a scope. This is my first clinical diag of pouchitis. I have had my pouch for 2 years. I requested a 14 day script for Cipro after doing some research. I went to CC Wednesday. After they scoped me, the results showed that the Cipro has helped and I only had 1 ulcer left at the suture line. Next week after getting off of Cipro, I need to start VSL#3 or a low dose thearpy of Xifaxin. It's an antibiotic that does not absorb very much in your system. I have been on FloraQ for 2 years. It sounds like you may have antibiotic-dependent pouchitis. There is a report that I believe is the most current, up to date one on our situation. There was no external funding recieved from this study. It was done by Dr Bo Shen at the CC. Do a search for "Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practice". It was published July 22 2005. I have to decide what to do here in a few days when I'm off Cipro. I hope this info is helpful to you. Jacks Tracks

Here's a link to the abstract which indicates fairly poor results for probiotics as treatment of chronic antibiotic-dependent pouchitis.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retri...197493&dopt=Abstract

Jan

Well that's not very promising. So where do we go from here?

I think I will not start the VSL #3 for a couple of weeks, then start small and see what happens.

Of, course I do not know if I really have Antibiotic Dependent Pouchitis. I have only had three treatment periods with either Cipro of Flagyl and all three times for only 10 days.

What do folks do when hope is lost, go back on a bag?

That certainly is an option. But, there are many meds to try before you get to that point. Some folks just don't want to go the med route and choose the ostomy to reduce their dependence on meds. Personally, I have no problem with meds, particularly since I feel that you can wind up on meds even if you have the ostomy (there's hundreds of things you can need meds for and for most of us it is a fact of life as we get older).
http://usagiedu.com/articles/pouch06/pouch06.pdf

But, for pouch management, there is not a great deal of good studies out there, so it can be trial and error for the most part.

Jan

EZ Money, The link Jan gave you is only a portion of the total report that is 8 pages long. In the full report I believe it says to be considered Antibiotic-Dependent means having 4 or more episodes a year. If you want the full report, go to my profile page and leave me a message and I will fax it to you or find a way to get you the information. I couldn't find it on the web so I had Dr Bo Shen email it to me. It's worth reading. A bag is not an option for me now because of all of the adhesions left in me from 4 major surgeries that my local surgeon did on me all within a 6 month period. I wish it was an option! I am in the same boat you are in. Hang in there. Jack

The link I gave in my last post is a 12 page full article by the Cleveland Clinic. In it, the criteria for both chronic and relapsing pouchitis are defined. Yes, you do need 4 or more episodes to be considered chronic.

Jan

This message has been edited. Last edited by: Jan Dollar,

Sorry Jan, My bad. I went to the link and my old windows 98 dial up computor only got me to the 1st page. Again I apologize. I posted that late last night when we got in and wasn't thinking clearly. If it wasn't for a post I read that you made about trying Cipro or Flagyl for pouchitis, I wouldn't have requested my local surgeon to scribe it for me. Because of it, I'm doing much better now at this time. You always help and give great information and I and everyone else appreciate it. Jack