If you have a new pouch, this could be just pouch adaptation and should improve with time. But, if it has been 6-12 months since you have been using your pouch, this may well be pouchitis. It is the first symptom I get. You'll know when this get worse instead of better.

Jan

I have the same problem. Been ove a year since surgery and just had a checkup.
I almost always have the urge but all is healthy down there. No pouchitis or anything. It is frustrating. I have no answer for you but I experience the same thing.

IMO if you're experiencing urgency that won't quit you might have pouchitis even if it doesn't look like it on pouchoscopy. A course of Cipro or Flagyl could be extremely informative, if the symptoms clear up within a few days.

Just a little clarification on Scott's post. If your pouch shows no evidence of pouchitis on scoping, you don't have pouchitis. However, you may still have bacterial overgrowth, which is also treated with antibiotics. If you have pouchitis symptoms that do not respond to antibiotics, it is likely IPS (irritable pouch syndrome). Then the treatment is the same as IBS.

Jan

Interesting.
I will show my surgeon this post if you do not mind.
Richard.

Better yet, Richard, show him the journal article in the Pouchitis forum (the "Sticky" thread at the top of the forum).

Jan

Ok... Will do!

I am quite certain that I do not have a pouchitis (I had pouchitis 2-3 times after I got my pouch which was in August '13).
It actually got better to this day...

About that bacterial overgrowth. I am currently on probiotics (Mutaflor), are probiotics also responsible for a (negative) overgrowth?

As far as I know the bacterial species responsible for SIBO (small intestinal bacterial overgrowth) are not the same as the species found in various probiotics. I certainly wasn't advised to curtail my (prescription) probiotics while I was treated for SIBO (with doxycycline). Also, pouchitis is a set of conditions that can present differently at different times.

The gut microbiome is profoundly complicated, and we understand such a tiny fraction of that complexity that we shouldn't be overly confident about any of it. The J-pouch microbiome won't be understood for many years after the colon microbiome is figured out, since there are relatively few J-pouchers. "This seems to work" is the best we can do at this point. The notion of "good bacteria" and "bad bacteria" (other than parasites like C diff) is almost certainly incorrect (or at least mostly incorrect), though it may help us get more comfortable with our nostrums than the more primitive-sounding "this seems to work."

My advice is to try things that seem to work for others, and to pay close, patient attention to what works for you. Your microbiome is probably quite different from that of others.

scott just read you tHread about you taking doxycycline for S.I.B.O?? CAN YOU ELABORATE..

how did you know S.I.B.O. FROM POUCHITIS? HOW DID YOU COME UP WITH DOXYCYLINE?how long did you take it and how did it work for you?

The symptom that made my GI decide it was SIBO rather than pouchitis was significant gas. The doxycycline (three months worth) seemed to fix me up.