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Reply to "Pouchitis found on biopsy ~ 30 days on Flagyl"

@Pouch2021 posted:

So Shen essentially said biopsy/histology is very sensitive but not as specific for pouchitis. Interesting. I read an earlier paper of his detailing a proposed scoring system for pouchitis which included symptoms, gross pouch appearance and histology. There was a certain point threshold one had to meet but essentially you need contribution of 2 out of 3 domains to get there (maybe 3/3, my memory sucks). He made the point that too many are treated based on symptoms alone, with unnecessary exposure to abx. I was treated empirically for pouchitis, felt better, then had a scope after 10+ days on cipro that was normal. Wonder if I ever had it to begin with or if inflammation had healed by then. Guess I’ll never know but I will push for a scope before taking abx again.

yeah but if you have pouchitis a few times a year , scopes sometimes take a while to have done or a lot just cannot afford the cost of them. A pouchoscopy done at Cleveland clinic under sedation would cost be about $2000 after insurance.. I have high deductibles, which are $3500.00 individual or $6900.00 family, so I would rather do a course of antibiotics first that cost me about $5.00 . If it doesn't help then I would look into getting a scope.

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