Can anytime explain these symptoms??

Pouchie, this is certainly a nuisance. SInce your pouch is only 2 month old, and recently inflamed, one possibility is that you had two things going on: a new, still adapting pouch as well as pouchitis. Are your symptoms (when you stop the antibiotics) every bit as bad as they were before any treatment, or are they a little better?

Another less desirable possibility is that you have antibiotic-dependent pouchitis. The healthy-looking pouch makes this less likely, though not out of the question. There are a bunch of things you can do to try to optimize your pouch adjustment. SInce you don’t say what else you’re doing, I’ll list a bunch of the things many (perhaps even most) of us do some (or even all) of:

1) Soluble fiber (like Metamucil). A couple of times daily seems typical, with breakfast and dinner. I use it with 8 oz. of water, and others seem to prefer less water.

2) Imodium or Lomotil. I use it at bed time only, and I get better results with Lomotil. Others use it during the day as well.

3) Probiotics. A very strong probiotic, like VSL #3 DS, helps some of us. I take an unusually high dose (2 packets at breakfast, 2 packets at dinner). It’s expensive, but the DS form is prescription-only and sometimes covered by insurance. I credit this with keeping me off antibiotics for a couple of years.

4) Low (or very low) carbohydrate diet. Some folks who can bear to do this swear by it. The more strident ones will imply that only a fool will eat carbs (or at least sugar) with a pouch. I haven’t managed to sustain such a diet, and it clearly isn’t a panacea for everyone, but I tried it for long enough to convince myself that it sure wasn’t a quick fix.

5) Antispasmodics. Especially during the adaptation period some folks have spasmodic pouches. Levsin or Bentyl can help.

6) Patience. During the adaptation period new sensations can feel like urgency, but most of us were able to gently delay bathroom trips longer and longer without necessarily having accidents. Try to carefully distinguish between true urgency (i.e. it’s coming out one way or the other) vs. an uncomfortable sensation that you can choose to ignore without a mishap. Obviously this is an unpleasant experiment in the beginning, but it’s critical that you understand what the sensations really mean.

7) Antibiotics. I’m on antibiotics all the time now, unfortunately, though they really don’t bother me particularly. I had my pouch for 6 years before taking antibiotics, though. I sure as heck went through all of the other steps first before settling on antibiotics, though.

I hope some of these ideas help you out. Good luck!

If no pouchitis when scoped, it could be bacterial overgrowth, irritable pouch, or maybe you simply rebounded to typical function during normal adaptation. I think it is most likely to be the later than the former. You probably are better served by taking things to help with function, than going back on antibiotics. Bowel slowers, fiber supplements, and probiotics may be your friend. Also, a limited diet until you get under control is advised.

Jan

Hi, I agree with Scott. Also, your pouch is very new, so be patient until your pouch adapts. You are lucky you are actually going to the bathroom very few times. I have had a pouch for 30 years now, and it only has about 60% capacity, which means I go to the bathroom around 20 times a day (on a good day). Be careful with foods, rice and potatoes are binding and always help slow movements down. I avoid onions, apples and lettuce as they cause too much gas; avoid spicy foods and hard nuts as they will iritate the pouch (walnuts are okay if you chew them well); avoid high fibre foods, mushrooms and peppers as they will cause blockages (of which I have suffered many over the years).  Over the coming years keep an eye on your iron, B12 and potassium levels. Also, get the medics to control your hemocrites. Most important, sleep well and take a good walk every day. I use Metronodazole anti-biotic every time I get a light bout of pouchitus, and sometimes add to that Ciprofloxacina if the bout is really bad (painful abdomen and swelling , light bleeding from pouch) . Also, Salofalk 1g suppositories help reduce swelling. Good Luck!

The thing is the recent scope didn’t show any evidence of pouchitis, however I have read studies that have shown symptomatic patients can have a normal looking pouch but biopsies show pouchitis (I didn’t have biopsies). It’s hard to accept this pattern is normal given when on antibiotics I only go 3-4 times a day without urgency being the key point, I would say that is normal function for me.

I haven’t noticed anything in my diet making things better or worse. Imodium also doesn’t seem to have an effect. When I had the ileostomy I was taking 40mg daily to control the high output and it didn’t really do anything. Same when I take it now really

I've had my pouch about 28 years and have to say the adjustment period for the pouch was very long......I don't recall how long and I've had many complications along the way, so I don't know that I'd be considered "normal," but 2 months is still very new. Over time things improved.....it took a good year for some sort of "normal"......but that has evolved with time, too.

Antibiotics are frequently constipating, so few bathroom trips can be a false sense of "normal."

I'm one of the ones who must avoid carbs and sugars almost exclusively. The difference is dramatic, but does require diligence.

Do you drink enough water? I have to drink a minimum of 6 glasses every day, more in warm months. Without it, especially in the first years, I was constantly in the bathroom eliminating water I wasn't even drinking. My temporary ostomy would fill like a balloon with water constantly, as well.