Fair enough, JLH - I may have overstated things. It's certainly true that if you are stuck with chronic pouchitis and run out of ways to keep it in check, you may indeed have no reasonable choice other than giving up on the pouch. So far I've benefited from reading Shen's pouchitis paper more carefully than my doc, but I guess if Cipro + Flagyl fails me I might not find an adequate alternative. I've alrerady started thinking that Xifaxan combinations could be something to try, if needed. Xifaxan alone did nothing for me, but the same was true of Flagyl, which nevertheless has been a perfect partner to Cipro in my body for a couple of years.