Help! having some issues

ICCMember

Hi Everyone,
I am thinking pouchitis, never had it before...

UC/pouch Hx - ICC 7 years. J pouch (3 step) celebrated 1 year post take down in May. No problems.

I woke up 10 days ago - Wed - with a headache. It is still going on. On that Friday I started sweating a lot and feeling hot. I took my temp Sunday and it was 101.8. The highest my temp has been is 103.4 and that has been in the last 2 days - Thurs & Fri. It goes away with motrin or Tylenol. Since Friday my joints have started to ache, I am tired all the time, and by body feels as though I have the flu. I have slightly increased my frequency of pouch emptying but no real increased volume. I have increased gas and have 'leaked' a little during the night, which I have never done. I went to the ER on Tues and the doc said I have a severe UTI (based on urinalysis) even though I have no burning or increased frequency. He said that it's possible to not have any symptoms and still have an infection. He put me on 250 mg cipro 2x a day for 3 days. I began reading up on pouchitis and thought my that I might have this. So I got the dose upped to 500 mg 2x a day.

I am 5 hours away from my surgeon doing medical rotations at a rural hospital - so I can't just up and run to my surgeon. So .... do you guys think

1. Is this pouchitis?
2. Do I need a scope?
3. Can I continue on Cipro without seeing my surgeon?

Thanks!
Erin

6/1/1212:33 PM

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SpookyMember

Sounds like it could be pouchitis, though since you have a UTI as well then you have a double whammy going on.

For now, keep taking the Cirpo. But call your surgeon and explain what has been going on. Your surgeon may suggest a longer course of antibiotics and may want to add flagyl as well, as the common course of treatment is both antibiotics. It may not be necessary to see your surgeon, as based on your symptoms, the meds can probably be prescribed over the phone. Your surgeon may then want to arrange to see you in a few weeks, though that might not be necessary if your symptoms clear up with the antibiotics.

When I had pouchitis, my surgeon was out of town, but I was able to get a call into him through my GP, and based on my symptoms, he phoned in a script to the pharmacy. I saw him when he got back; but then my symptoms had improved with the round of antibiotics. This may be the case with you as well.

6/1/121:29 PM

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Jan DollarModerator, RN, retired

I agree, if it is pouchitis, it is combined with the UTI, and maybe even the flu. A fever that high is highly unusual with pouchitis. If you get a fever at all, it is more of the low grade type. It is common to feel achy and fatigued, like the flu when you have pouchitis. But the hallmark symptom is the diarrhea that does not respond to any antidiarrheal medication. But, some people can have pretty bad pouchitis without much in the way of symptoms. Three days antibiotic seems short for a UTI, especially if it was considered severe. Usually, it is more like 7-10 days, closer to the course for pouchitis.

When I have pouchitis, I don't need high doses. 250 mg Flagyl works fine. But, I take it for at least 10 days.

They usually do not combine antibiotics for your first bout with pouchitis. That is only if the single type does not work. A year out from surgery, you can have this treated by a local GI, unless it is so rural that there are no GIs! Usually, a scope is not necessary, as they typically will diagnose based on symptoms, so a phone call to your surgeon should be fine. If antibiotics do not work, or make things worse, then you may need to be seen.

Jan

6/1/124:50 PM

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LifeLine999Member

Thanks for the advice, experiencing same issues.

Best Regards

Keith

http://www.lifelinefirstaidtrainingbelfast.co.uk/

7/12/152:35 PM

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TE MarieMember

My first post op ER visit turned out to be a UTI. I was embarrassed to find out it was a UTI. It was soon after my take down as well. I've had many UTI's and never had one that caused pelvic pain like this one. There was no burning as in prior ones as well.

In any event if the antibiotics don't clear it all up then you probably have some pouchitis as well. I hope you are feeling better soon.

7/12/156:19 PM

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