Hi!

After 20 years with colitis and a tip-toe to the edge of colon cancer, I now have a j-pouch and am about six-months post take-down. Knock on wood I have, for the most part, been doing great. I can eat almost whatever I want (still avoid spicy things but have indulged more freely in coffee and alcohol than I did before), sex hasn't been painful, I've had a mere 2 instances of butt burn, no continence or urgency issues, and am only going to the bathroom 3-6 times a day with 1-2 trips being at night.

A few weeks ago I had my first hiccup (and I'm currently waiting to talk to my doctor - it's been three weeks of trying to get proper answers to these questions and I'd like patient input until I can finally get an appt or return call). I had pain in my anus, it was difficult to go, I was going more than normal, and there was blood. The next day I was exhausted, the symptoms were less but still there. The next day, a Saturday, I felt better, was out and active all day, but still felt gross after eating. That Sunday night I was up every hour with diarrhea and had to call out of work sick. The next day I contacted my doctor's office to let them know what was up b/c I'm worried about pouchitis. However, I do have a number of friends that have had GI issues recently, I had swam in a lake with blue/green algae issues, and had a vodka cocktail the Sunday I wound up with all that diarrhea. I also have a new IUD, and was getting my period when this all kicked up. When I still had my colon my cycle definitely instigated symptoms so I wonder if there's a link.

My nurse blindly prescribed a prescription for Cipro, which also gives me stomach pain and diarrhea so I declined it until I can talk to my doc. I spoke to the nurse since and she suggested probiotics (which have never helped in the past) but didn't specify which type. Now I've mostly felt better since the initial dust-up, but I have seen a red tinge to my stool on occasion. Some times I'll still have diarrhea and then the next poop I have is perfectly formed bunny pellets and all seems to be fine. As I wait to speak to my doctor about cipro vs. flagyl vs. probiotics, I'll pose these questions to y'all as well -

-does pouchitis ebb and flow? Or is it possible it resolves itself?

-do other issues (like a bug going around, menstrual cycle, obstruction, or lake flu) cause pouchitis-like symptoms? 

-I know VSL #3 is popular with j-pouchers, any other probiotic recommendations?

Thanks, all!