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Reply to "First case of pouchitis - terrible"

There’s a bunch of biologic meds out there.  It really depends on your GI- they will evaluate your inflammation and maybe try something else.  It can take some trial and error to find one that works for you.  After years of doing Cipro on and off I was finally put on biologics when it wasn’t addressing the inflammation any longer.  Biologic drugs I’ve tried include Humira, Remicade, Stelara, and (lately) Entyvio.  Of all them Entyvio has been the most effective and is my GIs preferred med since it’s fairly targeted to the digestive tract and doesn’t do broad suppression like some of the others.  There’s even more in the Janus Kinase family that I haven’t had to escalate to yet.  

But I would guess your doctor will try something much less intense to start.  Maybe another round or two of Cipro, a short term prednisone hit, etc.  It also depends on how the inflammation is affecting you.  If you feel mostly normal it might not need addressing.  Mine is around my anastomosis, which is already strictured and causes me regular blockages, so we go after it pretty hard.  But that may not be the case for you.

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