Usually it is a ten day course, but I have been on them longer than that more than once. If you are having bothersome symptoms I would consult your GI as you can reduce to 250 mg X 2. I find I am more constipated at those high doses for a period of ten days or longer.

i still cant eat solid foods 4 months out or i strain non stop every hour. im living on ensure and that stays liquid and comes out easy but still way to frequent. what is going on with me? im so bummed. been on hc suppositories for a month and cipro 20 days. started out ok but last few days urgent spasms from anus to groin. im hoping its a side affect from either cipro the hc or my culturelle. when i first started the cipro my gas stopped completely but now 20 days later im all gassy again thats why im wondering about the culturelle but i dont want to stop and give the bad bugs a step up. i swear the gas is my biggest problem. sorry guys just feeling hopeless.

You sound like you have a stricture. Have they checked your pouch?

yes and no stricture. hmmm

I would not be at all surprised if this was a primary upper GI problem, and not related to your pouch, per se. Sometimes surgery can trigger other issues, such as dyspepsia, gallbladder problems, etc. It can seem that antibiotics are causing the problem, when it is very possible that they are only revealing something that was already there (by altering the gut flora). Gas is an extremely common symptom, and I just don't think you can relate it to just the rectal cuff. But, if your cuff is inflamed, it will react with pain and/or spasm to pretty much anything that is irritating, and gas is definitely irritating to the gut. It is not irritating in the inflammatory sense, but in the sense that it causes distention and pain. Sometimes probiotics help with this, sometimes they make it worse, and it varies by the type and even the different strains of the same species.

So, about the only thing you can do is go back to baseline (Ensure), and only change one thing at a time. That way you can really know how each thing affects you. When you change different things simultaneously or even within a few days of each other, you cannot tell what is doing what. 20 days of antibiotic should have done something positive if it was going to.

As to liquid vs. solid stool, I am not sure liquid is so bad, as long as you are continent and reasonably comfortable. My stool tends to run mostly liquid most of the time, whether my diet is liquid or solid, and as long as I can delay bowel movements and do not have a high frequency, I do not worry about it.

I agree with you that increased gas is very problematic, but a short course of Flagyl ALWAYS takes care of it for me. I've never had Cipro, so can't comment on that. I've had other antibiotics for unrelated infections without incident, but we are all different.

Jan

thanks jan, my gi gave me a prescription for vsl3 today and changed me from cipro to xifaxan. also said to lose the suppositories. he seems quite keen on this regimen. i asked him if the ensure could cause problems and he said he really didnt think so. im just leery of foods since my uc days and he says i have to lose that mentality or ill be limited to spinach and rice again...

Makes sense. Xifaxan is nice because it is basically topical, with little to no systemic effect, so you don't have to concern yourself about side effects. But, it is not universally effective (and more often than not, for persistent pouchitis, a combination with another antibiotic is more effective). My point is not to make you think it will not work in advance, but that if things go sideways, it probably is not because the antibiotic is making things worse, but that it is not effective enough.

Just a warning on the VSL#3 though. With as sensitive as you are, start out very small, like a half packet a day, and build up gradually, rather than using the full dose right off the bat. The main side effect people complain about is gas So, maybe you can head that off at the pass by the gradual ramp up.

Good luck!

Jan

i started this regimen yesterday and this morning im straining with crazy urgency. any ideas?

Sorry to hear of your troubles.

I can relate - what I do is:

- with major urgency use codeine to slow things
- seriously control your diet - essencial for urgency. When things are
bad I avoid fibre and things like tomato sauce, or anything complicated! etc. Thicken with oatmeal.
- I drink kefir with antibiotics as a way of stopping antibiotic related diarrhea (I have been on antibiotics for three years now.)

Good luck!