Short answer is no. There are other forms of 5-ASA drugs, but it sounds like you are not interested in them. VSL#3 and tumeric are “natural” options, but they work in a different way and may or may not be helpful for you. Most people tolerate them well, but the VSL#3 might give you a fair amount of gas and cramps at first. 

Give it a try and see how it goes. The only thing I want to stress is that inadequately treated pouchitis or cuffitis leads to complications too, so keep that in mind. 

Jan

I echo Jan as well, try the VSL#3 and see how you react to it, and if you can I would also try some Manuka Honey, preferrably the Comvita brand with a minimum of 15 UMF. I have had good success with it in keeping my cuffitis, and pouchitis symptoms at Bay. Cheapest place I have found it is on Amazon. It's a little pricey, but if it works then it beats taking the drugs you are taking, and it is good for you as well.  

I’m more than a little skeptical of “natural” solutions, since there tend to be some false beliefs about what that means, and what the advantages might be, and (worst of all) what side effects may exist. Nevertheless, focusing on the VSL question, it’s important to use VSL adequately, and that means a significant quantity is usually needed to have any effect. One VSL capsule is probably useless. I take an especially high dose (of the DS packets), equivalent to 32 capsules daily. This is quite expensive, though I’m pretty clear that I get real benefit at that dose. There’s no evidence that I’ve seen that it helps with cuffitis, but it seems to more clearly help with pouchitis. YMMV.

Scott, out of cicuriosi for myself, how many packets of the VSL#3 DS are you taking, and how are you taking it?

Thanks!

Sorry, curiosity!

I take four packets of VSL #2 DS daily, mixed with Greek yogurt, in two doses. Two packets at breakfast and two packets before dinner.

BTW, you can edit your post if you want to correct a typo or anything else. Look under “Take Action.”

Another thing to point out is that clinical remission (improved symptoms) and endoscopic remission (visual proof of mucosal healing) are not synonymous. Doctors have found that you really need to strive for endoscopic remission. Many of us were lulled into complacentcy by assuming we were doing well because our symptoms improved, but the inflammation remained when scoped. 

That is where I was and why I wound up on Remicade and Imuran.

Jan

Jan, have you ever come across an evidence-based explanation for *why* we ought to strive for endoscopic remission? Everything I’ve read/heard just seems like speculation.

Scott, It took a bit of searching, but I found this passage in the article “Pouchitis: What Every Gastroenterologist Needs to Know” (under the section Prospective View and Recommendations). 

https://www.ncbi.nlm.nih.gov/pubmed/23602818

”Patients with minimal symptoms but with endoscopic inflammation still should be treated to minimize smoldering inflammation causing chronic “stiff” pouch with transmural inflammation, which can result in pouch failure.”

While it seems like speculation, it is known that a chronic “stiff” pouch can become an unusable and failed pouch. There is no return from a failed pouch.

Jan

Thanks, Jan! I must have skimmed past that when I read the article.

Since most pouches exhibit some inflammation, at least on biopsy, I do wonder what the right threshold of inflammation might be to warrant treatment.

That is where the experience and skill of the clinician comes in. You cannot just go by the microscopic inflammation noted on the pathology reports (which we all have). 

Jan