Cipro & Flagyl vs Rifaximin

My 17 year old son had his takedown 6/2016.  Did great his first year, but now has a stubborn case of pouchitis.  He tried Cipro for 1 week which did not help and then Cipro and Flagyl for one  month which did not help.  Going to GI today to ask about Rifaximin  and possibly Cortifoam as the next step to try.  Has anyone had no luck with Cipro or Flagyl but then found that  Rifaximin did the trick?


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He takes the VSL capsules.  Although Dr said to wait until he is off the antibiotics and use it for maintenance since the abx will kill it anyway.  Then he said he will prescribe the double strength (hopefully ins will cover it).  He did not think a cdiff test was needed.  What is ischemic pouchitis?


Ischemic pouchitis is inflammation caused by a reduced blood supply to part of the pouch. It has a characteristic appearance (to experienced eyes).

VSL at a high dose helps me even when I’m on antibiotics. I take the VSL with breakfast and dinner, and the antibiotics at bedtime. Spacing them well apart reportedly helps. I take 4 DS packets per day, which costs a lot. My insurance now covers it, after a year-long battle.

After exhausting my appeals to the insurance company, I went through my state’s insurance regulator. The insurer fended me off for a while by treating it as a *coverage* appeal, but once I was able to force it to be treated as a question of medical necessity they ultimately caved. They even wrote up a very appropriate policy about covering it for other J-pouchers in the future. It took over a year and plenty of persistence. An evidence-rich letter from my doctor helped. I’ve posted all of this previously, including the letter and the insurance company policy, so a search on this site should turn up the details. Good luck!

Xifaxin is a great antibiotic if you can get coverage for it. I rotate it with cipro and flagyl and tinidazole. The only problem is my insurance only covers limited quantities of it so it’s only good for about a half dozen rotations and then on to the others. The other positive is that Xifaxin isn’t systemically absorbed and thus gives your skin bacteria a reprieve, lessening the chances of yeast infections and warts and other skin issues due to prolonged or chronic antibiotics usage.

My cost is $60 for 60 pills (1 month supply).  How many per day do you take? How long have you been on it?  Cipro or Flagyl didn't  help my son.  He's been on Xifaxin for 4 days and feels better already.  I'm cautiously optimistic.  I do not know how long he will stay on it yet.  I am hoping not it's not permanent. When you go off the antibiotics your pouchitis comes right back again?

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