I've read through lots of threads on here, but haven't found one that really addresses the issue of getting pregnant with chronic pouchitis.

A few questions out there for anyone who has or had chronic pouchitis and has gotten pregnant. After this round of antibiotics, we will be making our decision to move forward with trying to get pregnant. I'm not 100% sure that I have chronic pouchits yet as I'm trying to wean off the Cipro right now, but I've been on it for about 2 of the 4 months since takedown.

First, I know that Cipro is not a drug of choice to be taken during pregnancy. So, when do you make the transition to a safer antibiotic? Do you just wait until your pregnant? It seems like experimenting with new antibiotics when newly pregnant would not be a fun idea. But at the same time, I wouldn't want to be off the Cipro and suffering with pouchitis symptoms for months and months while trying to get pregnant.

Secondly, how well do safer antibiotics such as Amoxicillin work in comparison to Cipro and Flagyl? Also, can you take these while nursing?

Oh, lastly, I'm taking VSL#3DS twice daily. It says on the package to ask a doctor before taking during pregnancy. Anybody take this during pregnany? I don't want to be changing my probiotic regimen in addition to my antibiotics if I become pregnant. That just seems like too much to be changing at once. If I need to start altering things, now would probably be a good time.

Thanks everyone!!!

If it were me, I would wait a while until my situation were more stable. I know that's probably not what you want to hear, but unless age is a factor, I don't think I'd want to be pregnant so soon after takedown with such unstable circumstances. If you gave your body more time to adjust, you may be better off in the long run, as the first year with a j-pouch is full of adaptation and for many, not at all a reflection of how things are long-term. I had ongoing pouchitis for the first year but things improved after that, and the healthier you are going in to pregnancy, the better off both you and the baby will be.

I don't think I'd stay on Cipro until I got pregnant because the first trimester is the critical time for development and much of early development would happen even before you knew you were pregnant. But that's just me; you need to make decisions that you are comfortable with. If I remember correctly, Cipro is okay for later, but I can't remember for sure. What are the teratology ratings of the various antibiotics?

I would suggest meeting with an OB or perinatologist prior to trying to get their opinion on the antibiotic situation, I'm sure women conceive babies every day while on antibiotics, and you already know that some are better than others to take while pregnant.

Good luck.

Thanks for your input Breezie. The thing is...I feel like I AM stable right now. I'm doing great and am on only a very low dose of anitbiotics right now. I am going to wait until I either know that my pouchitis is gone or that the doctors are calling it "chronic" and we decide how best to treat it from here on out. I'm a believer in the longer you wait, the more time there is for something else to go wrong. So I am going to try to take advantage of feeling well.

They do classify Cipro as a "C" drug so it shouldn't be taken for the full duration of the pregnancy. They do not have much data on the tetragenic effects, but something you probably wouldn't want to risk. Flagyl should be ok for 2nd and 3rd trimester.

I've been waiting to hear back from my doctor on these questions for awhile, which is why I posted. I feel like my surgeon/GI will have more experience dealing with this than my OB, but I'll go to her next.

Thanks again and I definitely appreciate your thoughts and concern!

I am currently in my 3rd trimester of pregnancy. I have only officially been scoped and diagnosed with pouchitis twice in the past. I took 10 day courses of antibiotics and they seemed to do the trick both times. However, I recently had a flare, which caused some increased frequency (every hour) and cramping. I think it felt worse with the pressure from the babies. The Dr. gave me amoxicillan, which is safe for pregnancy and it worked, but I developed an itchy rash due to the penicllin...so no more amox for me. I only took the antibiotics for 5 days, and just stopped due to the itching. My gastro said I should come in to get Flagyl if it comes back. So, if you're not allergic to penicillen antibiotics, these are safe during preg and may work for you.

Good Luck!

Hi, I also suffer from chronic pouchitis and control it with cipro, proctosteroid (foam cortisone enema) and entocord (liquid cortisone enema). I have spoken to my doctor and surgeon about pregnancy and their advice is to not get pregnant while taking cipro. They suggested trying amoxicillin as an alternative, which unfortunately I didn't tolerate and caused me to break out in an itchy rash. However their opinion is that if I get pregnant taking the cortisone there isn't such a problem, especially with the entocord enema which is a topical cortisone and has virtually no effect on the rest of the body. I know of women who have taken relatively high doses of cortisone throughout pregnancy and had perfectly healthy babies. What I'm trying to say is why not try entocord as an alternative to antibiotics? I tend to take the antibiotics for a month or so when my pouchitis is worse and use the cortisone for maintenance. Good luck!

Thanks Janbrock. Since my post in August, I am pregnant now and treating my pouchitis with Augmentin and Flagyl. Doing well, thanks.

Congratulations! Hope things go well for you.

I think regardless of class of drug, you'll want to follow the "less is better, none is best"approach to taking medication. This most important week 3-14 or so during the critical development stage.

I had pouchitis during my first trimester and also hyperemesis (excessive vomiting). We made the choice to largely avoid drugs. I did try canasa suppository to help treat symptoms, but that does not go systemic.

I just suffered through it. The hardest part is that until your baby pops out of the pelvis around week 12, you have a stiff, inflamed pouch AND a uterus pushing on the pouch. I had horrible incontinence and slept on towels so that I could at least try to get some rest.

Eventually I got a PICC line (long term IV line) and home health nurses to come and give me fluids so that I could at least stay hydrated. Point being, there are much safer options than drugs to treat the threatening symptoms during your first trimester, though you may feel pretty miserable.

Keep in mind though that diarrhea usually is calmed by the hormones of pregnancy, so you'll have that helping you.

I blogged about my experience here: http://jennhearn.wordpress.com/

Good luck! I promise that even if you are the most miserable that you have ever felt in your life for those 9 months, you will soon forget all about it as soon as you see your little one.