What's most likely is your pouchitis isn't being well controlled by what you are doing. It's a low dosage and if it's "maintenance" then perhaps you built up a resistance and need to rotate antibiotics. I rotated 4 antibiotics at 2 week intervals when antibiotics exclusively was my treatment. As for the probiotics, they are most likely a placebo and/or are killed by whatever antibiotics you are taking. Probiotics are not an effective treatment for pouchitis in most individuals.

I certainly might be pouchitis escaping control by the Flagyl, and if that’s the case a different or additional antibiotic could do the trick. When Cipro alone stopped working for me adequately things changed very slowly, so by the time I clearly noticed the deterioration it had been going on for quite a few months. An abrupt change could also be a GI infection (C. diff, giardia, viruses, etc.) or a bad bit of food.

CT likes to claim that probiotics are placebos, which just isn’t true based on the research. It is true that they don’t work for everyone, and that they can require very large, expensive doses to do any measurable good. It’s also true that they are unlikely to be sufficient by themselves to treat active pouchitis.

I am merely suggesting to Bubba that any reliance he is placing on probiotics being an effective treatment for pouchitis, which is suggested by his post, is misplaced. His best bet to stop the accidents is to increase dosages of antibiotics, rotate antibiotics or both. Short term, I would also use Pepto Bismol for 3 or 4 consecutive nights at bedtime (and at last 2 hours after last antibiotics dosage) and see if that halts the accidents. It has for me in the past. But then you have to come up with a better treatment plan going forward.

The antibiotics mystery. It is enduring.  More or a combination may help with the sudden change.  

I was happily-almost-normal, with my floppy pouch overgrowth well controlled until Rifaximin ran out, insurance wouldn't refill, Canadian pharmacy will take 4-5 weeks for generic shipped from India, and NP hesitated to write Cipro as my Rifaximin was winding down which would have allowed me a few days overlap. I gave up and called my local GI. In the past, hard stops and starts of antibiotic always leave me with recurring symptoms. And indeed, so it goes again.  

Going to get in between Scott & CT here: I eat probiotic yogurt daily, possibly placebo, and I do associate it with positive outcomes. Or output, as if were. But I have also wondered if timing of the antibiotic dose relative to the probiotic makes a difference. Isn't the antibiotic knocking out some of the probiotic? I had planned to experiment around this, but with my current relapse  trinity of frequency, urgency and daytime seeping (thanks to the abrupt antibiotic regimen change) the experiment will have to wait.

I am really really annoyed with that NP.

Probably should have posted this in the rant and rave section. . . .

Thanks everyone. I typed this reply and then ugh, it didn’t save. So this will be a less detailed on. I haven’t tried roaring meds but haven’t only been on Flagyl for a year (since June) so idk if that would be an issue. I don’t think my doc cares what I’m on so I’m sure he’d be open to mixing things up with Cirpro for example. Never had him mention Rifaximin but have heard of it on this site before. Maybe I’ll mention that as well. I’m on Stelera for my arthritis so I figure that might help too but what do I know.

i take the probiotic bc I figure it can’t hurt. And doc recommends it. I’d I find out in 20 years that they don’t work then I’ll be upset but for now I’ll banking on the fact that they help, even minimally.

In the meantime I’ve been able to figure out when I have a loose feeling and can kind of clamp on down until I can get to the bathroom. When before I didn’t have to worry about it. My appt was bumped up to May 5, so that’s good.