Hi there... been having severe abdominal pain for over a week hasnt felt like Pouchits, I have IPS (have had my jpouch for a year now) and after several trips to my gastro & primary and tons of xrays, Ct scan and blood and urine tests they are now telling me that THINK I have streptacocal B (spelling) a major bacterial infection....and now in my kidneys?
but they are not certain!! ANYWAYS my primary care took me off Cipro and put me on this Clindamycin, which I was reading has bad side effects if you have gasto problems.. and can CAUSE colitis! I am having a horrible time with my Doctors at UCSD in San Diego and am wondering if ANYONE knows about this or if I should be on this antibiotic?! My pain is still there and my BMs are now painful and Im constipated... ER? WHAT DO I DO? This pain is in the upper abdnomin not near my pouch or kidneys and is more on the left. ANY HELP WOULD BE GREAT!??!!! Should I even be on this sometimes I think the doctors dont have a clue... on Jpouchers, and definately do not communicate amongst each other, even though I am constantly relaying all the details?! In the meantime I am still in pain and all they ever tell me is go to the ER. Go to the ER. which gets me no where, other than more frustrated and its very far away for me and I am a single mom of a 2 year old....

My main concern with Clindamycin is that it is THE top offender for causing c. difficile. For that reason, there is NO WAY I would ever have my kid on it. Not sure whether it's OK if you have never had c. diff. Seems to me the pain is not a good sign, and that your PCP should at least have checked with a GI before prescribing it. Do you have a GI, and can you call him/her?

I was thinking the same thing - I was hesitating before saying it in case I'm completely wrong but I think the colitis they warn you about is c diff-related colitis rather than typical UC. You probably do want to be sure your original UC wasn't c diff before you take it.

My understanding of the c-diff / clindamycin connection is that clindamycin is a broad-spectrum antibiotic that wipes out most every kind of bacteria except for c-diff (which often lives with us unknowingly). With all the competing bacteria gone, c-diff grows out of control, and can create toxins that can set off a bacterial colitis. Also, there are different strains of c-diff (A and B, I believe) - and I can't remember which is the troublemaker.

Regardless, if you have a strep B infection that is causing your problems, you need to get it cleared up and it probably becomes a trade off vs. the risk of being on clindamycin.

Has anyone suspected that your abdominal pain may be caused by adhesions and not some type of infection? Adhesions often do not show up on CTs or other scans (Small Bowel Series, for example), but can be in there pulling on things and causing pain. The only way to know for sure is for them to go in laproscopically and take a look - removing any they find.

Steve

What troubles me is why they would not know whether or not you have a strep infection, particularly if it is in your kidneys. Urine and/or blood cultures would be necessary for diagnosis and it can take up to 5 days for the cultures to grow out and be identified.

Also, unless you are allergic to penicillin, it or ampicillin are the antibiotics of choice. Clindamycin is not a first choice because resistance is more likely.

http://www.emedicine.com/Med/topic2185.htm

I agree, that it sounds like you need more continuity of care and it would make sense to be referred to a gastroenterologist or infectious disease specialist to manage this.

Jan