Cipro can mess with tendons in some people, so I think you ought to call your doc to discuss options. You may have to try a couple of different antibiotics to find one that can replace the Cipro for you, if staying on it turns out to be a bad idea (on balance). Good luck!

You are on a pretty low dose, but if you are sensitive, sometimes a low dose is not good enough. I get by without side effects by rotating antibiotics, with courses of no longer than two weeks.

Still, it is difficult to determine side effects for me because I have enteropathic arthritis and always have tendinopathies. But, since the arthritis was going on before I went on antibiotics, I am just trusting the symptoms are unrelated to the antibiotics.

I agree that you need to discuss this with your doctor. The last thing you need is a ruptured Achilles tendon!

Jan

Thanks guys. I'm going to call my GI doc tomorrow to discuss. The tendonitis was pretty bad today and my left knee is so stiff, now i'm too scared to take cipro. 

After Cipro and Flagyl what is generally next in line? (I would prefer to stay away from the fluroquinolines)

It's unusual to think about any antibiotic treating an anal fissure. For just pouchitis, though, they've been listed in previous posts many times, and a search for something like "Tindamax" would help you find them. Xifaxan (rifaxamin) is worth a try, and tends to have few side effects, but it's very expensive. Others include Augmentin, doxycycline, and a couple more I think I'm forgetting. Levaquin is similar to Cipro.

Nothing but Cipro worked for me, unfortunately.

Claire, I appreciate your concern. It's true that fluoroquinolones sometimes have troublesome side effects, and it's appropriate for folks to be aware of them. It's not true, however, that most Cipro users experience serious side effects. Horror stories from unfortunate folks who've had a bad time with a particular drug do more to muddy things than clarify them. I've been on Cipro nearly continuously for 5 or 6 years now. I'm able to get good results from a fairly low dose, which reduces the risk, and my tendons seem to be tolerating an active life (I teach martial arts). I haven't had a hint of C. Diff, thank goodness. Life is full of risks, and having proper control of my bowels is well worth the trade-off, IMO. People with good results don't usually post their stories online.

Every medication involves trade-offs and a risk of side-effects, sometimes serious. Inadequately treating conditions also creates risks, along with the certainty of symptoms. Blanket warnings against a particular medication can do more harm than good.

I have taken cipro in rotation with flagyl and other antibiotics for over 20 years now.  The only real side effect I have noticed (other than increased photosensitivity when I am out in the sun, thereby necessitating more tanning lotion than usually needed) is that if I stay on it too long and do not rotate onto other antibiotics (usually xifaxin which is not systemically absorbed), I am prone to yeast infections.  Being a man, they usually hit me in the legpits or armpits where I will start to feel itchy and notice a red rash starting.

Back in 2010, I had a monster yeast infection which spread down my legs from the legpits, and I am convinced that it was caused by a failure to rotate off cipro in a timely manner and staying on it too long.  As soon as I rotated on xifaxin, the yeast infection was broken (that together with anti-fungal treatment- diflucan).

From what my dermatologist told me the cipro kills bacteria in your skin, impacts micororganism balance in your skin and the fungi simply opportunistically populate areas formerly populated by dead bacteria.  You avoid this scenario by allowing skin bacteria to replenish by taking xifaxin which isn't systemically absorbed.

I rotate my antibiotics every 2 weeks like Jan Dollar.  Occasionally, and it only happens when I am on the cipro leg of my rotation, I will sense the beginnings of a mild yeast infection in the legpits.  I immediately douse with antifungal powder and rotate and it's all over.  It's never happened on a xifaxin or augmentin rotation.

Hi Guys, just an update. 

With approval from my Doc i stopped taking cipro. I have seen a major decrease in tendonitis although if i use any joint too much the tendons will get inflamed, this can range from sore achilles, sore knee, sore thumb joint or even carpal tunnel inner forearm soreness. I have been using magnesium spray which really helps and once my gut is settled i will try magnesium tablets to see if that will help repair the tendons.

Now, since i stopped cipro (4 days ago) my gut has been pretty good until yesterday. I am now experiencing watery diarrhea, but with no pain or fever. Is this because the cipro is coming out of my system or there is not enough good bacteria, or could this be C. Diff?  

p.s.

Claire - thanks, i appreciate the warning, and yes i think my body can't handle the FQ's, i will tell the Dr's i'm allergic to it.

Scott - i really think that there was some link between the onset of my pouchitis and the anal fissure, i don't understand it. My surgeon actually said that cipro is thought to have anti inflammatory properties. 

Drone-

If the diarrhea started after you stopped the Cipro then it's more likely to be recurrent pouchitis than C. diff. The Cipro would have done nothing to suppress C. Diff, though it could have thickened up the stool. Are you having urgency, or just looser stool consistency? C. Diff is possible, it's just not at the top of the list, I think.

Magnesium supplements tend to cause diarrhea, so you may want to hold off until you know what's going on. They really aren't a miracle cure, anyway. I'm glad your tendons are feeling better  - such a quick improvement bodes well for your limbs and joints, but you may have to start searching for a pouchitis treatment you can tolerate.

If you were straining on the toilet as part of the pouchitis it could help explain the fissure. Or it could remain a mystery.

Good luck!

Thanks for the quick reply Scott,

Ok, yeh this is probably pouchitis, its watery diarrhea with a bit of urgency.  As soon as i eat i start to feel urgency and the food just seems to go straight through me. I only ever get this reaction when I'm allergic or can't tolerate a certain food, but it usually goes away after 1/2 a day, this seems to be sticking around.

I have tracked down VSL #3 which has been renamed Viomixx in Australia. I have just taken 4 sachets to try and get this under control and Saccharomyces boulardii probiotic. I have also taken L-Glutamine 2.5g , which is completely experimental, recommended from a friend.

The VSL might do the trick, or it might help you get by with a smaller antibiotic dose. That has been my experience. Give it a few weeks to see what effect it's having.

You'll never be able to tell if the S. boulardi is helping, since if it's doing its job you don't get C. diff, and if it isn't doing its job you usually don't get C. diff anyway.

Thanks Claire, yes i actually got some nifedepine made up at the compound chemist, and it's better than rectogesic , plus no headaches or 12 hour breaks between use. 

I definitely need to report it, will look into that.

thanks for all your support and care

Just trying to get my head around why i have watery diarrhea post cipro. Keep thinking back to everything going haywire when i started VSL#3, but i thought to myself that's impossible, probiotics help not make things worse. So i did a bit of searching and found this

"Healthy bacteria may also produce gas and diarrhea -- but usually not for long. Until the "good" bacteria get a strong hold on the yeast environment caused by the "bad" bacteria, you may experience a bout with diarrhea -- if you didn't already experience those symptoms before taking probiotics. When the healthy flora takes over the internal environment of the body, symptoms of gas and diarrhea subside."

So, what do you guys think? do the probiotics need a few days to take over? could they be making things worse initially?

The strange thing is i don't feel sick, i feel pretty good, just with this abnormal watery diarrhea.

Absolutely probiotics can cause gut symptoms. Mostly gas, but also diarrhea. It varies person to person and with each strain of probiotic.

But, don't expect quick positive results from probiotics. It can take weeks or months for probiotics to colonize. 

As for diarrhea from Cipro, sure. Why not? ANY antibiotic can cause diarrhea as a side effect. Like any other med, side effects vary person to person. But, it is more typical during treatment. If the diarrhea persists, testing for C. diff is a good idea before trying other antibiotics. 

Jan

Hey everyone, just an update. I have been taking two sachets of VSl #3 morning and two at night and they have effectively taken over and now things are much more normal. 

I just wanted to add that i have been seeing some very positive results from l-glutamine (5g powder day and night) and i have read in several places that it has been used to recover from anti-biotics, chemo and stress on the body. I can report that it is helping my tendons,ligaments and muscles and even really helping with my arthritis (in combination with remicade) I have much less fatigue and it's also supposed to help repair the lining of the gut but im sure it needs much more time to achieve that. 

thanks for listening people!

-d