Puchitis and the Flu

It could be C diff, or you might just need a different antibiotic.  Flagyl is sometimes useful for C diff, and it's often effective on pouchitis. It might be best to get a C diff test before starting Flagyl. 

This thread is so timely. Three weeks ago I came down with the flu. Five days ago, I started to get pouchitis symptoms, which quickly worsened. I had been pouchitis-free and HEALTHY! for over 4 years!

I suspect this flare-up may have something to do with the amount of Tylenol I consumed (about 1000mg per day for about a week). I know paracetamol isn't considered an NSAID and is generally accepted as safe for j-pouchers, but I'm suspicious that it triggered my pouchitis. Paracetamol's mechanism of action is largely a mystery, but there is a notion that it inhibits COX-2.

I hope this is only temporary--I had such a great run of being healthy.

Yes, I know.  I  hate it.  Never thought that pain medication could trigger  pouchitis.   Need to see a doctor.  Output is very frequent.  Lost 4 pounds in a week and I don't need to lose any.   Just hope it isn't pouchitis.  Never had it before. What exactly are the symptoms for pouchitis.

AS ALWAYS, thank you!

I'm not aware of any evidence that Tylenol contributes to pouchitis. I certainly haven't experienced any connection, and I use plenty of Tylenol. Many folks report that their pouches (or their GI tracts more generally) get out of sorts when they have other medical issues, like colds. I've also noticed that connection. 

I know, it's bizarre. Maybe it's not due to the Tylenol, but I have noticed on previous occasions that my pouch would be irritated for a day or two if I took NyQuil one night. But of course it could also be due to activation of my immune system to fight the flu. I've had colds over the years, but they've never triggered a pouchitis episode. 

I now assume that I've developed some deficit in barrier function, which has allowed the bacteria in the pouch to get down to the epithelial cells, triggering an immune response. Antibiotics may kill off the bacteria, but will the barrier heal? That's the big question.

Had chronic pouchitis from 2010-2013, then was pouchitis-free from 2013-2017.