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Question about "antibiotic dependent pouchitis"

J j-poucherMember
I was curious as to whether or not anyone on this site has read a post or talked to someone with antibiotic dependent pouchitis that has found and alternative treatment to help their condition. I currently have to take Cipro twice a day, and Tindamax once a day to try and keep my infections at bay. As soon as I try to rotate off to a new antibiotic or remove either the Cipro or Tindamax then my infection will usually return within a a matter of days. As of late I have been continuing to decline in health, and while I might not have active pouchitis keeping me in bed, I usually suffer from constant fatigue or some other ailment that just zaps the life right out of me. With that said, I was curious if anyone had any alternative methods they have tried that allowed them to feel good and be antibiotic free. When my GI Dr diagnosed me with this condition he stated that I would have to be on antibiotics for the rest of my life as long as I continued on with the pouch, so I was curious if anyone knew of someone in a similar situation that has found another way to be pouchitis free and antibiotic free without having their pouch removed. I welcome any feedback as I feel that I will need to decide what to do next in order to improve my quality of life. If going back to the bag is ultimately the answer, then I am prepared to do so, however I want to exhaust any and all options before giving up on this j-pouch for good.i went thru hell 3 years ago in having this j-pouch built, so im hopeful that there is something else out there that i have not tried yet. Probably wishful thinking but it never hurts to ask. thanks in advance for any advise.
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clz81clz81Member
I was antibiotic dependent for over 2 1/2 years after my takedown. I have had wonderful success over the last 4 months or so taking Pepto Bismol morning and night and reducing my simple sugars intake. I thought I needed to rotate back to antibiotics a couple weeks ago...but turned out it was just the giant salad I ate. I was on for a couple days, made me feel worse, so I stopped and went back to the PB. I would definitely give it a try!
CTBarristerCTBarristerMember
Reduction in sugar and carbs in your diet is imperative if you have chronic inflammation being treated with antibiotics. The emerging consensus is that it is all caused by bacterial overgrowth due in part to the structural configuration of the J Pouch. Pouchitis reflects that some of us do not handle the bacterial overgrowth situation well. Eating sugars and carbs fuels that bacterial overgrowth situation. That is the long term solution to getting off antibiotics, and I have managed to reduce dosages of antibiotics by doing it. I am on my lowest dosages of antibiotics in 18 years.

Pepto Bismol will help clear up a bout of pouchitis. It has antibiotic like properties.
Last edited by CTBarrister
TinCanTinCanMember
Is it bacterial overgrowth or overgrowth of undesirable bacteria? I say this because I have taken both flagyl and cipro in the past to control pouchitis. Flagyl did nothing. Cipro was, and continues to be, quite effective. This suggests to me that the type of bacteria present may be more important than quantity.
CTBarristerCTBarristerMember
Cipro and flagyl actually work on different bacteria which is why they are often prescribed in tandem, thus giving the user the "shotgun effect" of a larger swath of coverage.

I think bacterial overgrowth as a term signifies the overgrowth of bacteria which in the particular person triggers an inflammatory response. However, there are plenty of people that have bacterial overgrowth and no inflammation. So what is undesirable for some people may not be for others. I think probably everyone who has a J pouch has some bacterial overgrowth, but in some it triggers an inflammatory response and others do not have the same response.
BM boy's momMember
question for CT Barrister, Jan and others -- who are finding reducing sugars and carbs helpful -- are you just eating protein? My son (13 year old son, 2 months post take, already cycling thru antibiotics, entocort and enemas -though it seems cipro is the only one that helps until it stops) has ben told not to eat fruits and vegetables (except for bananas and applesauce) if he gives up carbs -- he will only have protein left...curious what your diet looks like? Thank you for genrously sharing what you have learned.
Jan DollarJan DollarModerator, RN, retired
I do eat carbs, but it was not until I was way, way post op, like years, before I reduced them in my diet. I do not not know if reducing carbs wouls have been usefful early in the post op perios. It takes a long while to adapt.

But, now, nearly 17 years later, I eat much less carbs than I used to. My results re goos, pouch function-wise.

Jan Smiler

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