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Reply to "J pouch deterioration"

Richard-

Antibiotics currently work very well for me, though I had to step up to combination therapy (Cipro + Flagyl) a few years ago to keep them working. If that failed I’d try a biologic medication before considering retiring (removing) my pouch. Plenty of people get good results with biologics for chronic antibiotic-resistant pouchitis. If your surgeon hasn’t suggested this then IMO you need to consult a knowledgeable gastroenterologist familiar with the *medical* management of difficult J-pouches. Heck, if you haven’t tried combination antibiotics then this may be a failure of your surgeon’s knowledge rather than a pouch failure. If the right gastroenterologist isn’t available locally then you could consider scheduling a consultation with Bo Shen at the Cleveland Clinic. I don’t know if Shen could do some or all of this remotely, and I don’t know if your circumstances permit it, but that’s what I would do. Good luck!

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