Many folks can tolerate occasional NSAIDs without a problem. The fact that you developed pouchitis could be unrelated, or it could be connected. To work out whether there's a relationship in your case, you could stop the aspirin, get the pouchitis cleared up, verify for a while (perhaps a month or two) that the pouchitis stays away when you don't take aspirin, and then add the aspirin back and see what happens.

Does acetaminophen work for you? It won't bother your pouch.

Thanks Scott for the reply.

The acetaminophen did not work last time, but will give it one more try.

Is there any way to find out if I still have an active pouchitis other than the scopy? Because as I said, I don't have any pouchitis symptoms but the annual scopy showed that I have an active pouchitis. I am taking Apriso right now.

(I can not tolerate Flagyl for some reason)

Mayur

Mayer, there are two schools of thought on pouch inflammation with no symptoms. Some folks consider silent inflammation as a problem worth treating, and others consider it as a "normal" finding, not worth treating. It's a bit of a nuisance to treat, since the only way to tell if the treatment is working is yet another pouchoscopy. 

I'm not enthusiastic (for myself) about treating things unless they are causing a current (or at least well-understood) problem. What does your doctor recommend?

My doctor put me on Apriso (because Flagyl makes me sick). He wants me to come back after 2 months.

I hope Apriso will do the needful. Just trying to avoid another Pouchoscopy, I would keep monitoring for any bleeding. If that happens I am planning to take the Cipro.

Once a week aspirin should be OK as long as you do nothave GI symptoms. While it will affect your platelets and make bleeding more brisk, it will not necessarily cause pouchitis. But, all bets are off if you begin to have symptoms.

All pouches have some level of constant inflammation, so what is worth treating depends on the degree of inflammation. You were placed on a version of mesalamine, which is for IBD, so I would suspect your inflammation is not the minor, subclinical type.

Still, if you always have active pouchitis, it could be that the aspirin is contributing to it. There are many other treatments for headaches besides aspirin and acetominiphen. If you are having headaches as often as weekly, you probably need preventative treatment. Most of those drugs are not NSAIDs or pain relievers, but alter the brain circulation, among other things. I would see your primary doc about options in this area, rather than continuing on aspirin. Another thing to think about is the fact that when you take pain medication for headaches as often as weekly, you are more prone to have rebound headaches, so it is a vicious cycle. Prevention is better than treatment.

Jan