Paul, Pouchitis sometimes isn't obvious visually on scoping. IMO if Cipro helps you that much then you had Pouchitis. It might do the trick to use it for just 10-14 days. I'm not that lucky, and I've been on Cipro for years, with no significant side effects. No medicine (including Cipro) is perfectly safe, but I hope it works as well for you as it does for me, for as long as you turn out to need it to live a comfortable, active life. If you do need to stay on antibiotics then it's worth trying to find a few different ones that work for you. If that's successful then you can rotate them every 2-3 weeks.

VSL #3 DS can help reduce the frequency of Pouchitis. 

From what I've read, pouchitis symptoms that respond to antibiotics, but without evidence of pouchitis on scoping, is considered bacterial overgrowth. If you can get by just taking a course of Cipro from time to time, all the better. It is reasonably safe long term. Just be alert for side effects.

My primary concern about taking the same antibiotic long term is bacterial resistance. I have had to take antibiotics enough this year that resistance is a concern of mine. Even though I take antibiotic "holidays" of a few days to a few weeks, I prefer to rotate the antibiotics. Currently it is Cipro, Flagyl and Xifaxan. Works for me.

Jan

Thank you Scott & Jan. Have a Happy Christmas & healthy New Year.

Paul

ive had my jpouch for decades, and thought I understood pouchitis, but I learned quite a bit reading under the Topic area here titled Pouchitis, specifically pouch guru Bo Shen's papers have informed me that it would seem pouchitis has a wide spectrum of manifestations. and yes I agree with the thought that some pouchitis might be a form of SIBO especially as it responds to abx. I would also concur if its responsive then it must be. lol.