Advice with gas

I would treat your chronic pouchitis first and then see what happens after that; for Chronic Pouchitis, I would try Remicade.

Hi - I am sorry for your gas problems.  When your scope reveals chronic Pouchitis, are any medical treatments offered to you?

@Colonlessnurse Chronic pouchitis should certainly be treated, and could easily explain your issues. I don’t know if you’ve been offered treatment (and turned it down), but if not you might need to switch to a more knowledgeable doctor. Most pouchitis responds well to a course of antibiotics (usually Cipro or Flagyl), and may not come back for a long time (if ever). Many folks here might think of “chronic pouchitis” as synonymous with “antibiotic-dependent pouchitis,” but you don’t have any current reason to believe that you’d need to stay on antibiotics or other treatment. Biologic medications like Remicade would be a very poor choice at this time, when a two-week course of Cipro might fix you right up. So far your pouchitis is “chronic” only because it’s been untreated for a long time.

Thank you for your reply, Scott. After reading some discussions on this website I have realized that is probably what is happening. Every time I see my doctor, he asks if I am having any issues and explains the pouchitis and I’ve always said no. This is true because as I mentioned, my gas and bowels have been this way since 2008. It’s all I know. But I am now realizing it probably doesn’t have to be this bad, I’ve just been dealing with it not knowing any better. I will definitely talk to him. Thank you so much.

@Doug K posted:

Hi - I am sorry for your gas problems.  When your scope reveals chronic Pouchitis, are any medical treatments offered to you?

Usually my doctor asks if I’m having any issues and I say no. Because to be honest I always just thought this was something that came with the territory of having a j pouch. So it is probably my fault I have never been treated because I have never expressed my concerns with the gas.

That sounds like a great plan, @Colonlessnurse. Please let us know how it goes.  If you still have major gas issues after treating the pouchitis, that can sometimes be a sign of SIBO (small intestinal bacterial overgrowth). I had that once and was treated quite successfully with a different antibiotic.

I get horrid, explosive gas when I have pouchitis. That is usually my first outward sign. Yes, it is embarrassing. Get it treated - you will not believe the relief.