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I have a J Pouch along with Diabetes, diabetes 25+ years and counting, my PCP changed my Metaformin to XR Release Metaformin, this has helped in well formed stools but the Frequency of BM's has increased. Has anyone ditched Metaformin for anything else like Glucophage or Gyliburide?

Currently taking Lopermide, Lamotil, Tincture of Opium, Losartn (for BP) and XR Metaformin. Was on CIPRO and Flagyl for Pouchitis. Still having 15 BM's every day, Surgeon recommending to reversal to Permanent Ileostomy.

Any advice?

I think it’s important to start with an understanding of exactly what’s wrong. Has your surgeon offered a diagnosis? Do you have (or can you find) a gastroenterologist who might know more than your surgeon about non-surgical explanations and options? If you are being told that it’s chronic refractory pouchitis, have treatment options other than Cipro and Flagyl been tried? Other antibiotics? Biologics? Probiotics? “Pouchitis” should be considered treatable until a careful and thorough process of exploration has been undertaken and failed.

It’s tempting to fall into the trap of what amounts to despair, and surgeons also seem prone to this trap. If it’s “too hard” to figure out then a surgeon might suggest abandoning your pouch, rather than consulting a more knowledgeable doctor. For me, at least, it’s worth going to great lengths to get the best possible guidance. I’d travel to Cleveland and consult with Bo Shen before taking some surgeon’s advice to give up.

Good luck!

Scott F

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