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Reply to "Please help: Difficulty Evacuating Pouch"

I appreciate everyone's responses. Thank you.

Naturally, I fall somewhere in-between all the opinions. I do not want to take any medication without my OB's approval and the approval of a GI. I would prefer not to take any meds at all--which is what I did in my last pregnancy with a pouch and what I have done for the majority of my time with a pouch.

However, this pain--though it seems mild by old UC standards--is not really livable. By the end of the day, (because it is worse at night) I am really in a good bit of pain--to the point that I don't want to get up and do anything because walking, going from sitting to standing and vice versa makes it worse. Besides that, it is likely that pouchitis or whatever else could be going on would possibly be dangerous for the baby as well. As my husband said yesterday, the stress alone and my (currently) unusual eating habits have to be considered as well. How healthy is that for a growing baby, you know? I will try VSL as long as it is okay'd by my OB, but I did have a hard time even taking Floraster, so I am a bit skeptical as to how much help any probiotic would be right now. The Kefir does not seem to cause any issues, so I will continue to drink that daily.

My plan is to call the GI's office today, and assuming they answer (which is a little iffy with this office) to pass along a message to the doctor asking him if he would rather prescribe an antibiotic now for pouchitis or wait and do a scope/meet with me/telehealth appointment first. I will defer to his expertise, BUT I will say that I plan to be very, very firm about my timeline here. If he wants to do a scope before treatment, then I want to do it ASAP, some time this week. I cannot wait around in pain longer than that. My surgeon is too far away to be much help, but I have sent my records from surgeries to another surgeon's office here in the city. The Referral Officer there had already said they could schedule me as soon as they had records; so, if that ends up being the quicker route, that is what I will do. (Hoping it doesn't piss off the GI. But...again, speed of reply/help and empathy are big needs for me in a doctor.)

My biggest question right now (besides, of course, what is wrong and whether or not I need a scope before treatment, and how quickly I could get treatment or diagnostic scoping, etc.) is: My OB okay'd flagyl, but up until recently flagyl was considered dangerous during the first trimester. Some women online even claim it caused miscarriages. The data is really sketchy. Older data says it is dangerous--newer data says it is not and that benefit outweighs risk. I would rather not take it, just in case. I would feel more comfortable with amoxicillian, which has long been considered safe during pregnancy. Has anyone here ever treated pouchitis with that antibiotic?

I plan to run it by the GI today in my message, but I am afraid he will say no--because it isn't considered to be a treatment for pouchitis. Obviously, people are given it for pouchitis, though...and if it is safer than flagyl in the first trimster, I don't know that I see the harm. At any rate, I would prefer to try amox first, particularly if the GI wants me to wait for a scope. If it doesn't work, we could always reassess.

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