Probiotics tend to have reduced potency during a course of antibiotics, but I nevertheless find them helpful, at least at a high dose. Doctors don't usually recommend them because there is very, very little evidence that they help in most circumstances. It's a reasonable idea, though, and won't do you any harm. The idea of "good bacteria" makes it seem simpler than it is. A healthy gut has thousands of bacterial species, and a probiotic usually contains just a few.

My GI just put me on a course of of augmentin for a bout of pouchitis and told me to refrain from taking my VSL#3 while on it.  Previously, I have heard that it is good to stay on it while on antibiotics, as long as you wait several hours between taking the probitic and antibiotic. Thoughts?

Hattie,

I believe its at least three hrs. between the taking of antibiotics and probiotics.  I always take probiotics while taking antibiotics then double up for a week after. 

since I have had cdiff in the past I get worried when taking antibiotics for a bout of pouchitis or any other illness. but when I have to I always take a yeast based probiotic once a day with my antibiotics and then for a week after. I bought one from Amazon but not sure name of it right now, but I have also taken S.Boularrdi as well.

It is interesting, I was listening to NPR about "good and helpful" bacteria in your intestines and it seems to be science that is agreed upon, yet many doctors seem to question what seems like proven science.  I'll see how things go, maybe I can be a good test case -- how does having potentially lowered bacterial levels in the pouch due to Amoxicillin affect function!

Some get diarrhea but I have heard antibiotics firm the stool up more, I have had both so I don't know..lol

Just finishing a round of clindamycin for a finger infection and now have pouchitis.  What's weird is my stools are sometimes hard to pass, not firm (haha) but painful and with that urgency and incomplete emptying feeling like when I had colitis.  One day it was like boiling hot sauce coming out and gave me a painful rash.  Going today to fill a script for flagyl.  MD wants a sample to test for c-diff, which I know I don't have, I'm a nurse and you just know!  Anyway, just complaining to the peeps who understand.  

Nearly two years ago my doctor was stumped about all of my loose bowel issues and high nighttime activity. (Got my pouch in 1987 at age 23).  On a good night I go twice, usually at 3 or 4 hour intervals.  Luckily I am able to go right back to sleep and feel rested in the morning.  BUT, on a bad night, it's every hour or 1 1/2 hrs, accompanied with some pain and cramping.  THOSE nights are miserable and I feel like a zombie in the morning.  I chalk those nights up to what I call "offenders".  Food or drinks that my body didn't like that day... 

I get regular (every six months to a year, depending on how I'm feeling) sigmoidoscopy's.  4 years ago, the doctor found ulceration on my small intestine.  But, I had been taking many doses of ibuprofen for over a year before I saw him, and I believe that's what caused it.  He said, "It looks like Crohn's." I said, "NO WAY!  I feel great except for the pain in my small intestine.  I work out 3 times a week, I have lot's of energy. "  Sure enough I didn't test for positive Crohn's.  After about a year (2 more scopes later), the ulcerations had been improved, but still existed. He still has his suspicions that it's Crohn's.  I don't agree.  

In the past, he had given me Flagyl (500 mg) to use as needed for pouchitis.  But, it wasn't helping with keeping things quieter at night.  So he told me to take it every day, and added Ciprofloxacin (500 mg), after the Flagyl alone stopped being really effective.

He said that the problem with inflammation is that you don't want continuous expansion and reduction because that tends to wear out the pouch and overall create more issues.  He said that I should take both the Flagyl and the Cipro every day for the rest of my life.  Which is now what I'm doing.  

In the past I tried a probiotic, and it gave me MANY trips to the bathroom.  I am kinda scared about doing it again.  But, I wasn't on an antibiotic the last time I tried.  So, maybe now it may be helpful??  

Does anybody else take both Flagyl and Cipro every day?  If so, how is that working for you?  Do you also take a probiotic (3 or more hours apart), too?

I'm brand new to this group.  I'm sorry if I rambled or if this is not the right place for my post.  It's my FIRST post. LOL!  

Thanks for listening!!

Theresa

Hi, Theresa. I take Flagyl and Cipro daily, as well as a maximum dose (4 packets daily) of VSL #3 DS. This combination is working very well for me, and has for a couple of years. I have done and learned some things that might be of some use to you:

1) I didn't go on two combined antibiotics until neither one alone was working. Two medications means double the risk of side effects. 

2) I experimented with the doses until I found the lowest effective dose of each. A lower dose reduces the risk of side effects. 

3) I experimented with the administration and discovered that taking them once daily worked just as well as more frequent doses. This makes it much easier space the antibiotics well away from the probiotic and dairy (dairy and calcium interfere with Cipro).

4) I take the Flagyl and Cipro at bedtime. I take the VSL with breakfast and dinner.

5) I take Lomotil only at bedtime, and I'm lucky enough to almost always sleep through the night. I also use psyllium fiber with breakfast and dinner, and have done so since my surgery in 2002.

6) With careful experimentation I've found that I can tolerate moderate alcohol use, in spite of the Flagyl. YMMV!

Please don't hesitate to ask any questions, either here or in a private message. Good luck!

Scott - 

Thank you so much for all of this information!  I DO have more questions.

1 - What are your mg dosages for the Cipro and Flagyl?

2 - What form is your psyllium fiber in?  Is it Metamucil?  Have you tried various brands of the psyllium fiber and found one better than another? (this a multi-question question..)

3 - Do you restrict your diet in any way?  I have trouble with raw veggies, too much sugar (natural inflammatory, of course) and I avoid whole kernel corn completely.  EXCEPT, I HAVE to eat tortilla chips, corn tortillas and corn bread from time to time.  I don't have much problem with those types of corn products, in moderation.  

4 - Have you tried ground flax as a fiber additive?

5 - Lomotil doesn't stop you up the next day?

6 - I have found that alcohol is an offender.  Not to my pouchitis, but to my ulcerated small intestine.  SO, I pick and choose when I drink, and keep it pretty moderate.  Wines, gin and cognac seem to bother me lately.  I don't have much trouble with vodka or rum. PHEW!

Again, Thank You so  much for all of your help, answers and insight!

Theresa

i have same problem copra 1000 doesn't work any more i have to combine flagel also . A doctor recommend try flagel rectally hate being on drugs but i really don't have a choice.I really don't think diet helps , i saw dr Bo Shen, he believes in only in protein, very hard for me .

I take 250 mg of Flagyl and 500 mg of Cipro, both at bedtime.

I tried the Metamucil capsules but found they didn't mix sufficiently with everything else. I now use a 50/50 mixture of Metamucil and Konsyl powders, since I find full-strength Metamucil too sweet and too full of calories. I use the directed amount of water and it works just fine - I really disagree with the "use less water" approach.

My only dietary restriction is moderation of high-residue foods. I have a small salad instead of a big one, for example. Otherwise I eat a bit too much of everything. This is partly about not caring what my poop looks like. Everyone is different, though.

I have not tried ground flax.

A single Lomotil at bedtime doesn't stop me up at all the next day.

Good luck!