Hi Steve...this happens to me to.  Once I started to need to be on antibiotics it seems like I am great but within 3 month or less (at times) I am back to pain, butt (extreme) problems, fissures, diaherra, etc.  I actually just called the dr. this a.m. to see if he would phone in another round of cipro.  I am scheduled for adhesion removal surgery in June and I am sure hoping I feel better before then.  Is this what happens to you too when you are done with antibiotics for pouchitis.  or do you have another need for antibiotics.  I have pouchitis, cuffitis, and 2 large ulcers in the  j pouch plus fissures.  Ugh...

Patti

Patti, the last  time I had an apt, he said my pouch looked good and that there was no problem, but once I am off have  crapping along with diahera , I have tried probiotics and

fiber along with other things and they just don't seem to make a difference

SIBO (small intestine bacterial overgrowth) has the same symptoms as pouchitis without evidence of pouch inflammation. Treatment is the same though, antibiotics. Most people also need to severely limit carbohydrates, which help feed bacterial overgrowth.  Have you discussed SIBO with your doctor?

Jan

I have been rotating antibiotics for 20 years.  I can't get off of them.  If you can handle them you can take them for a long time but you have to rotate to keep them fresh and effective.

Jan, that is interesting, I never knew of that and I hate to say it I love my carbs, but that is an interesting thought, I must say for years on this forum you have always had good interesting comments about certain things. I will address this with my doctor. I must say I love rice it seems to bind me and I do enjoy bread, so it may be something I should look at cutting back. Have there been studies done with people with J. Pouches and this SIBO

Thanks for your feed back

Ct Barrister, thank you for your comment, I was wondering if you could, use antibiotics for a longtime and still get benefits from them with you it seems to have worked what is your change ups in this. I have always used cipro and flagyl, what are the other antibiotics that you use.

thanks

Steve

To curtail SIBO or pouchitis, cutting back carbs and sugars is a must.  Doctors tend to oversell J Pouches by telling the would be J Poucher they can eat everything - which isn't really true for the subset of J Pouch patients that end up with chronic pouchitis and SIBO. Plain and simple, carbs and sugars feed pouchitis/SIBO like dry wood and paper feeds a fire. 

SteveMac,

I rotate cipro and flagyl with xifaxin and augmentin, change it up every 10-14 days and occasionally throw another antibiotics into the mix. It's like pitching in baseball, you need to mix up the pitches to keep the bacteria in check just like pitchers mix pitches to keep hitters off balance.  Same concept.

Hi Jan..how does one know if you have SIBO...maybe this is my culprit too.  It's amazing how carbs and sugars can hurt ones' body.  My daughter has severe eczema and I often wonder if diet can help her too.  I've read alot about sugars and carbs and never heard of sibo.  Any info would be greatly appreciated.  I'm having what appears to be a flare up again of pouchitis or may cuffitis.  My bottom is raw again and cramping, diarrhea like stool, almost granular like and leakage.  Dr.Shen wants a lab culture done again to check for c diff before he puts me on antibiotics.  I am scheduled to have the adhesions removed in June.  I never did get approved for the hyperbaric oxygen treatments to try and see if the ulcers would heal.  Have a great day and thank you.

Patti

Often it is a process of elimination. If you respond well to antibiotics, yet there is no indication of pouchitis or Crohn's, then SIBO is a likely culprit. We are more prone to it than those with a colon because we lack the ileocecal valve that separates the colon from the small intestine. So, bacteria can travel upstream from the pouch into the upper small bowel. This is one good reason not to try to reduce your frequency too much, because fecal stasis just promotes more bacterial growth (like a stagnant pond as compared to a running stream). Tough to find that happy medium!

http://en.m.wikipedia.org/wiki...bacterial_overgrowth

One test often used is a hydrogen breath test, but there can be false positives and negatives.

http://www.ncbi.nlm.nih.gov/pm...1856094/#!po=37.5000

Jan

CT You are right  My doctor never told me to stay away from carbs but he did tell me to watch my sugar intake.  I found out on this sight about carbs and sugar.  I should have realized that because carbs turn into sugar and carbs was one of the foods that I didn't have pain with digestion outside of getting pouchitis.