How to Get Your GI Doc to Let You Try an Antifungal

Hey Kevin,

I have had fungal issues in the past. Mainly thrush after 3 weeks on Levaquin and fFagyl for a severe digestive infection in January. I was given Nystatin swish and swallow. I'm pretty certain that it caused fungal issues near my pouch exit as well. I use AD after every movement now. I also went on Diflucan for 7 days and that cleared things up. It had no negative effects on my pouch. I saw a difference after 1 or 2 pills so you could probably try it. Your GI should be able to do a pouchoscopy to test for fungus no?

That's good to hear. I've never tried an antifungal, but it seems like so much of our treatment is trial and error. Because I already tried an antibiotic, I will certainly bring this up and see what my GI doc thinks. I'm still trying to get in for an appointment. Like many good GI docs, mine is booked solid, but I can usually at least get in with his nurse.

I did have a massive yeast infection, on my legpits and groin area, when I was on a very high dosage of antibiotics coupled with Entocort a few years back.  Various antifungal creams were tried with no success and this infection continued to worsen for several months until I started an antifungal pill, Diflucan, and also rotated off cipro and flagyl and onto Xifaxin. Once I did the latter two things, it cleared up pretty quickly.

This was a confirmed yeast infection-any dermatologist can scrape skin and confirmed the infection after looking at the samples under a microscope.  Usually takes 30 seconds.

I have been told that an internal yeast infection, unless you are a woman and it's vaginal, is much less likely. But not impossible.

My thinking is a guy would see signs of yeast infection on your skin first- jock itch, in the groin, under the armpits and on your feet (i.e., "Athlete's Foot").  It's always been the case with me, I will see a little red patch in my armpits and then douse with antifungal powder and it goes away.

Your skin is the body's first line of defense against any infection and I would think a fungal infection would manifest first there- unless you breathed in mold spores or something like that.  Anyway my own history from taking antibiotics for well over 20 years to treat pouchitis is that I can see it on my skin first.

Thanks CT. I was under the impression that internal and external yeast/fungus infections could be mutually exclusive, but I could be wrong. I did have an issue with my armpits burning a while back, and a switched from a drugstore antiperspirant to a natural deodorant, which helped. I still notice the skin around my armpits looks a bit orange/discolored. I wonder if this could be a sign of a yeast infection?

I have also been following a very low carb/ketogenic diet, where I basically only eat meat, vegetables, and healthy fat (olive oil, coconut oil, avocado, grassfed butter), as well as taking VSL#3 daily. I have definitely noticed an improvement. I am starting to believe that many, if not most people with Crohns/colitis/j-pouches would benefit from a carb-free diet. I think people have a hard time accepting this, due to the dietary/social restrictions. At this point, anything that makes me feel better is worth the slight inconvenience in tweaking my diet. I'm hoping long-term I will still see improvement.

As far as armpit rashes, I have noticed the beginnings of a fungal rash by a redness appearing in the armpits and also some itchiness.  I have had great success using Zeabsorb-AF powder to douse these infections usually within a couple of days.  The areas where I seem most prone in the past were armpits, legpits, and groin area.  I never had any issue with my feet.

My GI doc just got back to me and wants me to get tested for h. Pylori tomorrow. He thought the pain in my abdomen above my navel sounded suspicious and not poichitis. If that is negative, he'll probably do a scope to see what's going on.

Let us know what happens. If you are positive for the fungal infection I will be curious as to how they treat it and how you got it. If negative a scope is probably a very good idea. Could be that you have inflammation/Crohn's above the pouch as I do. And if so the next step would be Remicade or some other biologic.

Will do. I will say, the abdominal pain kind of feels like when I had colitis, making me wonder if it's Crohn's. I tried Ramicade for a long time when I had colitis and it never worked, but I've never tried another biologic, such as Humira. I will definitely keep that in the back of my head. The pain feels very localized (center of my abdomen 2 inches above my navel) so would be interested to see what a scope revealed.

I went home for lunch today and had a sandwich and took some VSL #3. I immediately got very nauseous and got the sensation like my pouch was "sweating," where my rectum kept getting very damp. It wasn't incontinence. It was literally like it was sweating, like it was damp with clear water. I also had to keep urinating. This has happened in the past, and I have no idea what this means. Has anyone else ever had a similar experience, or can provide a guess as to what kind of reaction that is? I took an anti-nausea pill, which at least help subside things so I could go back to work, but my stomach is still cramping and feeling nauseous. I'm guessing lay off the VSL#3? Unless that's just my pouch adjusting to things?

My GI doc just called and I told him I was still having mid-abdominal pain and nausea. While we wait for my h. pylori test results, he wants me to take Prilosec to see if that will help. I've had C. diff before, and noticed a past post where it was discussed whether Prilosec makes one more susceptible to C. Diff. I already take VSL #3, but I was planning on getting some Florastor (s. boulardii) to hopefully prevent me from getting C. diff again.