Dr. wants to put daughter on 40mgs. Steroids with slow tapper over 8 weeks with antibiotics. I asked about Elevil and was told would take 8 weeks to work-so..no. I hate to see her on Steroids again.
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If the diagnosis is pouchitis, and cuffitis isn't suspected, then this is surprising to me. Are there complicating factors? Prior antibiotic failures? Other symptoms (e.g. joint pain)? An allergy you haven't told us about?
Pouchitis typically responds incredibly well to a course of Cipro or Flagyl.
She had a bleeding ulcer in K-pouch, along with a few other smaller ulcers. Had to get ulcer treated, cauterized, clamped. Blood transfusion. The week after initial scope -with suspected pouchitis, she starts bleeding from the pouch. 2nd scope treated the ulcer. Between hospitalization and 1st scope-no medication was prescribed. Waiting for biopsy (inconclusive). Six days into hospital stay, they start 200mg. x3 of Rifaximin, then state that if she doesn't notice a decrease in pain (sharp pain in her lower back when she intubates) they will start her on 40mg of Steroids. So hate the thought of this.
My husband has always been put on antibotics and step up the VSL.
Rifaximin also surprises me as a first choice, since it fails to work for many of us (though it's wonderful when it works). I'd pick Cipro, unless there's a reason not to. In any case, good luck!
Instead of prednisone in treating my pouchitis my doc put me on course of entocort which was helpful and since it mostly (though not entirely) targets the gut rather than systemically strongly affecting the whole body, there are less systemic side effects. Also there is now a new foam form that is inserted rectally which shows promise in actually targeting pouchitis in preliminary studies. I think it is called Uceris.
Daughter is allergic to Cipro. Problem they feel is the amount of pain she is in. I will ask about the Entocort.