It sounds like pouchitis to me. Night time incontinence, daytime leakage, increased urgency and increased frequency are the core symptoms. I would call your GI and get scrips for cipro and flagyl. Take for 10 days and if symptoms stop after a couple days, that will confirm it.

I agree that pouchitis is most likely. It’s usually easy to clear up, and usually only 1 antibiotic is necessary (I prefer Cipro).

Thank you for your replies!    It makes sense since I also have cramping etc.  

I really love this forum.  I don’t feel so alone with these medical issues knowing others are also dealing and can understand.

ask for Tindamax if your insurance will cover it. cipro can cause tendon issues and neuropathy..

Like most drugs, including Tindamax (tindazole), Cipro occasionally has serious side effects. These are especially rare when the use is limited to a couple of weeks at a modest dose. Cipro is more likely to actually work for pouchitis than tindazole, which is why Cipro is the first-line treatment for pouchitis. Tindazole can cause seizures, neuropathy, and blood problems, and may be carcinogenic, but it’s also reasonable to use in the appropriate circumstances.

I agree that Cipro should be 1st choice, and failing that Cipro and Flagyl in tandem as they are two very different antibiotics from different antibiotic families and work on different types of bacteria thus providing "shotgun" protection against all potential bad bacteria.

Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic, Whereas flagyl aka metronodazole is a nitromidazole. As my GI says they provide "different coverage." But in tandem they provide more coverage. To use a comedy analogy would Bud Abbott or Dean Martin have been as effective as straight men without their counterparts Lou Costello and Jerry Lewis, answer is no.  Ditto with Laurel and Hardy.  Of course there isn't anything funny about taking antibiotics, especially chronically. But I have been taking cipro for almost 30 years for pouchitis and I haven't experienced torn tendons or anything like that. It does make your skin sensitive to sunlight so load up on sunblock if you go to the beach.

That being said if it's a first time bout with pouchitis, cipro alone may be enough. If it recurs and become chronic, see the above.

Thank you all!!

I am just going by what Dr Shen suggests from his research. I agree Cipro works well as I have taken for years. I do have neuropathy now but no idea if caused by the Cipro.. I cant take flagyl as it makes me very nauseaus , but i have no issues with tindamax.