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Hi: I'm about 20 years post op. Wow, it's hard to believe that when I read it.  I'm still learning things about my pouch.  A couple of weeks ago I thought I was getting pouchitis, but before getting on meds, I decided to get on here.  I took some advice someone had given a while back and tried Pepto and cutting out sugar. It helped a lot (along with my normal probiotic).  I'm really seeing how sugar (sweets) can cause a bacterial build up and give the bad bacteria something to feast on.  I'm hoping this approach keeps working.  I can live without the sweets, but hopefully will be able to keep the regular carbs.  The reduction in gas by taking out sugar is amazing.  Just thought I'd share.  Thanks to all who have given advice.

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Pepto Bismol is very effective at combatting Pouchitis because of its bactericidal properties, but what I think it does is thicken stools rather than slows down motility, as does Imodium. My question to the other posters in this thread is whether they are also taking Imodium which does slow down motility. Bismuth subsalicylate changes the balance of fluids in the intestine which is a different mechanism of action that results in thickening of the stools. If the other posters are taking Imodium, opioids or other bowel slowers, they are blaming PB for the mechanism of action of another drug.

Of course, thickening the stool as opposed to slowing transit times creates the same problems for someone prone to obstruction, so if that is the bottom line concern, the differences in mechanism of action do not matter. It is important however to understand how these drugs all work.

After a flare begins, between antibiotic dosages.  Never take PB within 2 hours of antibiotics or any other meds.

I don't flare that much TBH because Remicade controls my situation, but occasionally if I attend a birthday celebration and eat sugary foods it is a culprit to start something and then PB nips it in the bud.  I view PB as an outstanding over the counter supplement to assist other drugs in combating pouchitis.  Some people have had success using it exclusively, but it is not supposed to be used chronically but rather only in short bursts.  Chronic use can damage the liver.

Last edited by CTBarrister

I might give Pepto a try. The sugar thing is probably a good idea too... gotta get my self-control in shape! I’ve never been completely inflammation free since surgery. After my annual scope last week they decided to put me on a round of Cipro 😞 I’d love it if I could figure out something where my pouch actually looks completely healthy. 

Me too!!

I had symptoms since January of this year and I didn't realize what I had until the middle of May when the symptoms turned really ugly and brought me to hospital.

Two different antibiotics, total 2000 mgs per day, three weeks off work and a 1000 mg suppository to use for 6 weeks.

Horrible!!  I want concise answers.  

Pepto does help.  I find buttermilk helps too.  I just learned buttermilk is beneficial for the digestive system.

Does anyone think espresso or coffee causes symptoms? 

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