Pouchitis or Something Else?

DeathStalkerMember

I've had my J-Pouch since 2010. This past Spring I started getting more urgency following a virus I had. Since then, it's been on-off again. Symptoms include:

1) urgency to use the restroom after eating similar to my UC days

2) liquid stool but no blood - much like food poisoning

3) gurgling sounds from the intestine after eating

4) a general feeling of fatigue. Not fever per say but just feeling tired

5) bloated all the time.

6) more frequency with restroom visits

I've tried Levaquin and that worked for a while but then wore off. I also tried Ceftin which used to work great for me but this too has lost impact. I've been on imodium since 2010 but that seems to have no impact anymore.

My next course of action is to get another colonoscopy to see what's going on with the pouch. Does this sound like pouchitis? I've gotten cuffitis over the years but this seems like a whole new issue. I almost feel like I've had long term mild food poisoning.

8/2/189:41 PM

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Scott FMember

This sounds like pouchitis to me. C. Diff should be tested for (when you haven’t been on antibiotics for a while, if possible). A pouchoscopy may give more information, but it also might not clarify things much. Assuming it’s pouchitis there are other antibiotics worth trying: Flagyl, Xifaxan, tindazole, Augmentin, and a few others. Perhaps one will knock out the pouchitis thoroughly, but it’s possible that you might need to stay on treatment. Sometimes a combination of antibiotics is necessary (I’m on both Cipro and Flagyl, having added the Flagyl when Cipro alone stopped working). Sometimes a biologic medication is effective with (or instead of) antibiotics. Do you have a gastroenterologist who seems to know about pouchitis? Good luck.

8/3/182:31 PM

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DeathStalkerMember

Well, I just started Cipro yesterday and within about 12 hours, symptoms completely disappeared. This thing is definitely bacterial in nature. What scares me is that the same thing happened when I took Levaquin back in April and then the stupid pouchitis symptoms came back. Seems like the bacteria responsible are able to adapt pretty quickly

8/4/1811:49 PM

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Jan DollarModerator, RN, retired

Many of us use antibiotic rotation to avoid antibiotic “fatigue,” or resistance. I was doing pretty well with that, but eventually my GI wanted me to try Remicade and Imuran. I have been in a sustained remission a couple of years now with no antibiotics.

Jan

8/5/184:02 AM

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DeathStalkerMember

Jan, what is typically rotated with Cipro though? Was wondering what antibiotic I'd want to switch onto once the Cipro's magic runs out.

8/8/1811:21 AM

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CTBarristerMember

Xifaxin, Augmentin, Tinidazole, Keflex, Flagyl. You don’t want to rotate onto anything in the fluoroquilones family of antibiotics like Levaqcuin. They work on the same bacteria and are too close. My rotation is cipro, flagyl, tinidazole and Xifaxin.

8/8/1811:31 AM

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DeathStalkerMember

It seems like your doctor is following the recommendation in this article - Cipro, Flagyl, and Xifaxin. Interesting: https://www.healio.com/gastroe...do-you-treat-pouchit

8/16/1811:48 AM

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