Hello Everyone,

I would like to see whether or not you agree with my GI's recommendation. It makes sense to me.

History

9/29/06 - All in "One-Step" Jpouch surgery

12/24/06 - Bad Pouchitis - Cipro - 10 days (worked very well)

1/08/07 - Pouchitis returned a few days after ending Cipro (milder pouchitis)
-took 2 weeks flagyl. (worked good)

1/16/07 - Had a surgical dilation - (Docs think that the stricture was a main cause for the pouchitis, as things were backed up.)

Ever since I stopped flagyl, I feel like I still have a mild form of pouchitis. 6-9 bm's a day, 1-2 night. As the day goes on they become more frequent, watery and urgent. Possibly some blood.(Im color-blind, so its rather hard to distinguish between dark red and brown). I am no where near miserable, but not quite perfect.

My GI told me to take Cipro - 250mg (1x daily) -for 3 months along with VSL#3.

Based on your experiences, do you feel that this is the right approach? 3 months is LONG committment. Or would it be better to try one more time a strong dose of Cipro and then stop antibiotics all together? Also, after how many days shall I expect to see a difference on being such a low dose?

Thanks for your advice in advance!

Keith

This could be worth a shot. Short-term Cipro AND Flagyl. If you take a probiotic with this, take the anti-biotics in the morning and the probiotic a few hours later.

Then, after you finish the anti-biotics, continue with the probiotic long-term.

Wishing you the best.

Personally, I'm not sure of the value of taking the VSL right through the 3 month course as I'm sceptical about the value of taking both at the same time. My view is that each time you take another Cipro dose you'll be killing the VSL bacteria and wasting your money but I recognise not everyone is with me on this one. If you're getting it paid for by your insurance then it's not really your problem but if you're bearing the cost yourself then it's another matter. I'm also curious about whether the amount of VSL bacteria you're ingesting could be somehow diluting the effect of the antibiotic.

I can see some rationale though for starting it about a week from the end of your cipro course to (hopefully) establish some kind of a colony before you stop it entirely.

Keith,
When I was on long term Cipro for Chrnoic Pouchitis, I still took Pro-biotics - just not at the same time. I no longer take either, but I would take Cipro first thing in the morning, then the probiotic a few hours longer. I'm sure more people will be along to help answer your questions. Long term Cipro is not uncommon.
DeAnna

There is a probiotic you can take with Flagyl and possibly (not sure about) Cipro because the porbiotic is a yeast rather than a bacteria. It's called Florastor.

Lori

Do you think that taking the Cipro (one dose daily - 250mg) would make any difference whether or not it was taken in the AM(while being absorbed when the pouch is filling up from food intake) or at bedtime(when the pouch is the most empty).

Keith

It shouldn't matter. Just take it at the same time each day and if you are going to take VSL, take it 12 hours later. This way you are taking your probiotics at a low trough of the antibiotic level and there will be plenty of time for it to do something before the next dose of Cipro.

By the way, low dose antibiotics are commonly used for chronic or recurrent infections, not just pouchitis. I had recurrent bladder infections at one time and was placed on low dose Septra for a year. I have not had a bladder infection since and that was more than 20 years ago. It may not work for you, but it is well worth the try. If the symptoms still return, you may be able to get by with chronic low dose therapy, thus avoiding many of the side effects.

Jan

DeAnna - you mention that you had chronic pouchitis and now you don't take antibiotics or probiotics. Please tell us how you overcame the chronic pouchitis. Also - why don't you take probiotics?
Ted.

SO it is now Day 2 on my very low dose of long term Cipro - 250mg - 1x daily.

I think it is working very well. It is now 11pm and only 5 bm's so far today and no urgency/pain in between. Hope this continues!!!

keith

Hi Ted,
Fortunately for me, I no longer have the pouchitis. I take 4 lomotil a day (first thing in the morning b4 breakfast) and this works great for me. If I know I am going to eat or drink something that will cause a little more output, I take 1 lomotil beforehand and am usually fine. After much suffering and it just "going away", I don't complain when I have a bad day. It took a few years of experimenting with the lomotil on how many and when. My five year anniversary is in April and I couldn't be happier....except my hernia surgery that I'm having next month. I am a little nervous about that. Don't know why, with all the surgeries we through (and I had a 3 step) you'd think this would be a breeze.
Good luck to everyone!