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Hola All-
I hope each of you had a joyous and loving holiday season. I'm extremely blessed to have had a house full of kids returning home from school and their respective homes far and wide. A truly wonderful gift! One four-legged grandchild, but no bi-pedal models yet!

I'm getting ready to make my second visit to the Cleveland Clinic in about 10 days and would appreciate any perspective that you may be able to offer me before I make the drive from the Wild and Wooly North. I'm about 30 months post colectomy and 27 months post take-down and am still a long way from where I had hoped I would be at this point. I've had persistent cramping, diarrhea, urgency, discomfort and general listlessness since my surgery. I have also had 6-8 obstruction episodes, including 3 ER visits and one hospitalization with NG tube. Major YUCK!

About a year post-surgery, my surgeon threw up his his hands and referred me back to my GI to take a stab at getting things under control. A year later, my GI hoisted the white flag and I now find myself out where my UC was originally diagnosed in 1980, the Cleveland Clinic. My first modern trip there was last October. They tested for bacterial overgrowth, did a contrast study, a pouchoscopy and 2 or 3 other tests. The upshot was to have me do a course of Cipro and a super expensive second antibiotic, the name of which escapes me at the moment, which were quite effective but had no lasting effect once the regimen was complete. They then prescribed Cipro and Flagyl, with the same results- good effect, but recurrance of symptoms as soon as I stopprd taking them. I'm currently on a lower dose of Cipro alone, with mediocre results.

Anyway, to get to the gist, the docs have talked around the diagnosis of "chronic pouchitis", which they all sort of mysteriously describe as "difficult to treat", and I expect that they will officially hang that label on my lower tract next week. So, my questions are (and I reserve the right to add to the list!) What experiences have any of you had with this particular bogeyman? I understand that it often entails a perpetual cycle of varying and recurring antibiotics. Thoughts and experiences regarding side effects? Do any of you have dietary suggestions based on your experiences? On my first visit, I saw a doc named Emily Carey, whom I liked very much. She is currently on maternity leave, and I will be seeing a doc named Jessica Philpott. Have any of you had experience with her? I believe that she works closely with Dr. Shen, so that offers me encouragement. What do you think were the most important questions for you to ask your docs?

I know I seem to be sort of adrift, but any wisdom and experience that you think might be helpful, I would greatly appreciate.

Many thanks in advance for the help!

Be Well!

Trevor
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I've had antibiotic-dependent pouchitis for a few years. Cipro did a very nice job for quite a while, but Flagyl never touched it. More recently I've tried Xifaxan (the expensive one) with no results, and doxycycline (presuming bacterial overgrowth) with pretty good results. I haven't altered my diet, but I probably should. Most commonly recommended are "low carb," "low FODMAP," and "paleo." Most folks would also recommend a serious probiotic (I use VSL #3 DS, 4 packets per day). I was able to delay needing Cipro for a couple of years with just the VSL.
Scott,
You take 4 packets of VSL per day? Do you notice a difference if you take less? I was on antibiotics for the past few years(only 1 tablet every second day) as I weaned myself off them and kept on the lowest dose that kept me pouchitis free. I haven't been feeling 100% lately and went for a scope. Surgeon said I didn't need antibiotics, and told me to get back on the VSL, and put me on Salofalk (mesalamine) suppositories for a bit of cuffitis inflammation that she saw. But I thought one packet per day would be good. My only symptoms are a bit of cramping and a slight sense of urgency very low down. Do you think VSL helps with those kinds of symptoms?
C.J.
I've had Pouchitis from day 1. 14 years and still have my pouch but seriously wonder at times about my sanity. I have been on just about every med if you check my signature. Currenty back on UC meds. canassa and pentasa after a short dose of xifaxan and endocort. Also trying my hand at Honemade kefir which has about 60 billion probiotics in it and about 30 different strains. Lots of anti inflammatory vitamins. It's a roller coaster for sure and I'm always thinking this is the end. I'm trying but it's hard to get off carbs and sugar. Also have fecal transplant right now on the back burner since I got myself into a remission.

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