antibiotics/extra frequent pouching

Hey, didn't your handle use to be Sierra Barb? Welcome back! Sorry you are in such a pickle with the UTI. Gee, is it possible you have a small bowel C. difficile infection? With all those antibiotics, I'd sure wonder. But what do do about the stupid UTI. Long time ago I had problems with recurrent UTIs and my urologist put me on long term, low dose Septra (same as Bactrim), for a year. Took are of the UTIs and didn't mess up my gut. But, that was before colectomy (but long after my UC diagnosis).

Jan

HI Jan, Thanks for the quick response. Yep, same Sierra Barb - could remember my old moniker but not the login...so just reregistered. Yes, I had a course of Septra last year, but thought I was allergic to it: such severe leg & foot cramps as I've never experienced, antic-feeling, inability to sleep while on it - I mean several days up...If I remember, research turned up quite a few others with similar symptoms, and I think, while the drug is the most common UTI remedy here, it's been banned in UK....Anyway, my internist was sure I was simply dehydrated, but I've gone through periods of IV hydration a couple times a week, so I know what that feels like. I was consuming at least 3 liters a day, but ileo sluicing can wreck havoc even with that consumption. I had a milder but similar response on keflex last week, so now am on Macrobid. How would I know if I had a c diff infection? It's a culture, no? I feel perfectly normal when I'm not on meds for UTI. Hike, kayak, cook, eat, write, all with zeal....Maybe I need to look at longer term something....I am seeing a nephrologist intermittently, and he determined that my long-time liquid waste and sluicing is due, not to inadequate fluid consumption,but lack of salt - so lack of ability to hold onto fluids. Now taking sodium bicarb and that really helps! I will talk to his office but waiting to hear your other suggestions/response Thanks again. Barbara

Well, if you have no GI symptoms after stoping the antibiotics, probably not C. diff. There are urinary antiseptics that are not quite antibiotics, but you already tried one of the primary ones, Macrobid.

I suppose you've tried things like cranberry extract...

Jan

Thanks, Jan. I drink cranberry juice, but apparently I should take extract all the time (and the juice is the sweetened kind, not good for my gut flora). I only have three more days of the Macrobid, so I"ll wait it out to see if my gut symptoms abate. Right now I feel just as I did when my J pouch was chronically infected and I was perpetually on antibiotics. It seems pretty clear that this time, the prior antibiotics were doing in the gut balance, so I"m taking probiotics again. In your experience, does that help even when one is on antibiotics or antiseptics (I didn't know that's how Macrobid works as the Rx was phoned in)?

Macrobid, a urinary antiseptic, is supposed to act only in the urinary tract, because the kidneys concentrate it there. It is not supposed to alter colon bacteria, I guess becauseit is absorbed before it gets there. Still, it can cause C. diff infections in some people. But, with no colon, maybe your risk of gut flora effect may be higher. I couldn't find much in the way of info about probiotics with Macrobid, but I would think it should be fine to take with it, just space it out from the Macrobid doses.

Here is a link with lots of info about UTIs and the urinary tract:
http://www.urologyteam.com/node/359

Jan

Thanks for the link, Jan, and for info on Macrobid. My gut flora seems to be returning, so the Macrobid must be working as you described, although in the link, it's not listed as an antiseptic but as an antibiotic. The UTI still may be present, so I'm upping fluid and getting a cranberry supplement. It's been so hard to stay hydrated: I sluice waste through my ileo, and only recently started on sodium bicarb after seeing a nephrologist. That's helped with diarrhea. I take heavy doses of the equivalent of benefiber (it's no longer avail) - bought 50# of it from Archer Daniels Midland. Both Methenamine and the D-mannose sound interesting if I can't lick the UTI. I think the imbalance in gut flora I had was from the prior use of Keflex. I"m taking the probiotics regularly, as well - can't hurt.

The article you linked is excellent. Section on vaginal thinning applies to me. I am very careful about hygiene but had no idea the very high percentage of UTIs attributable to e. coli. Thanks again - as is familiar from my prior time here, I feel I have a skillful ally in your responses.

Yeah, Macrobid is an antibiotic, in that it kills bacteria internally, but it is only active in the urinary tract, so is often classified as a urinary antiseptic. I guess it is an old term, and I am dating myself...LOL

Jan