I've had my jpouch since 2001 and have had pouchitis on and off ever since. But I've used flagyl suppositories to keep it in check for at least 13 years. there are zero side effects since very little is absorbed into the blood stream unlike oral medications. They work almost instantly, a few days at most. I just had a scope and my doctor was amazed at how there was no inflammation. I would highly recommend the suppository route if concerned about antibiotic reactions.