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Quick question fellow pouchers:

Would antibiotics work if there was no inflammation?

I've had urgency, pain, pressure and some incontinence for the past 10 days, progressively getting worse. I am now on cipro/flagyl and feel much better.

I was also on cipro/flagyl about 3 weeks ago for the same thing. If the symptoms that I have were caused by food or PMS, for example, would the antibiotics work to resolve them? Or, can I be assured that they would only be working if there was actually a problem like pouchitis or some kind of inflammation?

I am about 4.5 months since take down and am wondering if these symptoms are part of the normal adjustment or if there is something else going on.

Thanks!!
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Your symptoms could be part of normal adjustment. I had many bouts of pouchitis over my first year and after and now at over two years, I rarely have issues with pouchitis. I was on and off antibiotics more times than I can count over the last couple of years and often for long periods or time (mainly cipro). My issue has mainly been cuffitis versus pouchitis (but have had both) and the antibiotics for some reason seem to help that also. It should improve as time goes on.

My surgeon was never concerned about my being on
chronic antibiotics for many months after surgery and I think it was because he often saw improvement with his patients over time.

Whether or not antibiotics help if no inflammation is present I am not sure about. You could have bacteria overgrowth that antibiotics also help with. Also note that all patients always have some level of inflammation in their pouch even if asymptomatic.
For Bacteria overgrowth not all antibiotics do the trick. Like Flagyl isn't for SIBO but Cipro might be in low doses mixed with Lactulose or something (how Dr. Shen had me set up). I was switched to Tindamax since that fights bacteria and I did a 3 course, 14 day cycles on and off like prescribed. since I got c.diff on cipro so I can't take Cipro anymore. Tindamax actually knocked my SIBO out. I don't take antibiotics anymore but I watch my diet.

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