Dangers of Cipro?

I’ve been on Cipro for 16 years.  I did have to add Flagyl about 8 years ago to maintain effectiveness. Cipro does come with risks, but I’ve not been affected by them. I’ve kept the dose pretty low. Cipro seems to generally be the most effective treatment for pouchitis.

It sounds as though you may be in the "antibiotic dependent pouchitis" category if the pouchitis returns when you discontinue the Cipro & Flagyl.   But that assumes it is actually pouchitis and not a functional problem or cuffitis.  Is the diagnosis based on pouchoscopy?

Cipro carries a "black box" warning that alerts to the risk of serious side effects.  My community GI was willing to prescribe though my specialist was not.   I was on it for several years, unable to reduce dose below 500 mg a day and often needing to increase the dose or add Flagyl or Tinidazole.  While on it I  had recurring tendinitis that may have been related.   Taking Rifaximin now and doing well on it.  

My colorectal surgeon performed a pouchoscopy 1/23/2024. He stated that pouch looked good. However, he indicated in test results that there was granularity and mild inflammation. The nurse practitioner prescribe Cipro and Flagyl based on my symptoms - excessive diarrhea, cramping, urge to go with no results. The "pouchitis" flareup started 3/28/2024.

I have made an appointment with a GI doctor in Cleveland who is highly recommended by a New York Dr. Schen, supposedly the best GI doctor for J-pouch and related issues.

Unfortunately, my appointment isn't till mid July which is typical of Cleveland Clinic if you are not established as a patient with a new doctor.

Dr. Shen is my doctor.  Cleveland Clinic is a good place to go.

Your scope results sound a lot like mine.

Cipro and Flagyl are definitely worth a try.  It's usually given for a few weeks or up to a month as a short course "first line" treatment.   You may feel much better quickly.  I did when I first used it.  And then the  docs at Cleveland Clinic should figure out what's going on.

It took me a few years for the pouch to settle down - Much longer than I'd expected.  But things do get better.