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I developed acute pouchitis ten years after the surgery this March. I have been on CIPRO x2/day @500mg.

I tried to reduce my dosage to once a day but I relapse. Anyone here on long term CIPRO treatment, like twice a day?

also, anyone who was diagnosed with acute pouchitis here who successfully tapered off the antibiotics?

I used to get minor pouchitis in the past but 2-3 days of antibiotics will fix it.

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I’ve been on Cipro since 2008, just 500 mg once a day without obvious side effects. When Cipro alone eventually stopped working at that dose I added Flagyl 250 mg once a day, and the combination has been working well for about 7 years. If you have to stay on antibiotics it’s best to try them all in the hope of finding a few effective ones that you can rotate among every 2-3 weeks. Flagyl, rifaximin, and Tindamax are some common alternatives.

A few folks have posted here about success getting off antibiotics for chronic pouchitis (without switching to a biologic medication), but it doesn’t seem to be widespread.

@Scott F posted:

I’ve been on Cipro since 2008, just 500 mg once a day without obvious side effects. When Cipro alone eventually stopped working at that dose I added Flagyl 250 mg once a day, and the combination has been working well for about 7 years. If you have to stay on antibiotics it’s best to try them all in the hope of finding a few effective ones that you can rotate among every 2-3 weeks. Flagyl, rifaximin, and Tindamax are some common alternatives.

A few folks have posted here about success getting off antibiotics for chronic pouchitis (without switching to a biologic medication), but it doesn’t seem to be widespread.

Thanks. I read your earlier post & know you doing good with one CIPRO. However, it seems I need two caps a day. As soon I switch to once a day, I relapse. Maybe I should add flagyl? I don’t want to get on biologics.

If two CIpro are working well then that may be a reasonable solution for you. If you haven’t tried the other antibiotics (individually, at first) then I think you’re doing yourself a disservice. I wasn’t able to make it work, but I wish I had several antibiotic choices to rotate. In that case two Cipro a day would just be one of several regimens you switch up every few weeks. Maybe Flagyl alone will do the trick, too, at the right dose for you.

@Scott F posted:

If two CIpro are working well then that may be a reasonable solution for you. If you haven’t tried the other antibiotics (individually, at first) then I think you’re doing yourself a disservice. I wasn’t able to make it work, but I wish I had several antibiotic choices to rotate. In that case two Cipro a day would just be one of several regimens you switch up every few weeks. Maybe Flagyl alone will do the trick, too, at the right dose for you.

Oh no, other antibiotics didn’t work at all. I tried both flagyl & amoxicillin. Maybe I need to discuss other antibiotics with my doctor.

Have you tried tapering off the meds to alternate days, what my doctor recommended in the beginning?

I have chronic pouchitis.  I started with 500mg Cipro twice a day.  It worked for awhile and then I started getting symptoms. I tried switching to flagyl.  That didn't work. So I now do Cipro in the morning and flagyl at night.  I've been on these since February 2019 and haven't had any side effects.  I was able to lower the dosage to 250mg each. I eventually got off both for about a month before the pouchitis returned. I'm back to 500mg of each. Hoping to get back to 250 each and that's where I'll stay.

Adam21, I was on Cipro and other antibiotics continuously for 25 years- is that long term enough? Although it was not 25 years of continuous Cipro, it was 25 years rotating Cipro and other antibiotics. The longest I stayed on Cipro continuously was for 6 months @ 1000 mg plus 1000 mg flagyl. I was also taking Entocort. This unfortunately led to a massive outbreak of yeast infection and warts in my groin area, called by my dermatologist "the worst outbreak he had seen in 30 years." He cured it however, by freezing the warts, giving me diflucan and zeabsorb AF powder for the yeast infection, and pulling me off cipro and flagyl in favor of xifaxin, which isn't systemically absorbed and therefore allowed my skin bacteria to recover.

Apart from that episode and sun sensitivity manifesting in quicker sunburn and greater need for sunblock, I had no other side effects from Cipro apart from seeing an occasional rash start in the armpit and then quickly stop when splashed/doused with Zeabsorb AF.

No joint or tendon issues and no issues mixing with booze. I remember during that 6 months I was in Montreal for the Jazz Festival and got totally bombed/smashed drinking all kinds of booze multiple times while taking Cipro with Flagyl.

Scott F reports he has been able to get away with it for 13 years and that might very well continue for him, but if he gets to a point where he needs Entocort to boost things that could be the game-Changer on side effects. It may have been for me.

As far as the toxic effect on the liver, unknown, but didn't effect my liver chemistries like methotrexate did. I asked my GI about long term cipro use back in the late 1990s and he famously quipped to me, "you are the Guinea Pig on that." Well the Guinea Pig made it through 25 years and now I am on Remicade and doing well. I have managed pouchitis for around 27 years overall. Liver has not shut down so far.

Last edited by CTBarrister
@CTBarrister posted:

Adam21, I was on Cipro and other antibiotics continuously for 25 years- is that long term enough? Although it was not 25 years of continuous Cipro, it was 25 years rotating Cipro and other antibiotics. The longest I stayed on Cipro continuously was for 6 months @ 1000 mg plus 1000 mg flagyl. I was also taking Entocort. This unfortunately led to a massive outbreak of yeast infection and warts in my groin area, called by my dermatologist "the worst outbreak he had seen in 30 years." He cured it however, by freezing the warts, giving me diflucan and zeabsorb AF powder for the yeast infection, and pulling me off cipro and flagyl in favor of xifaxin, which isn't systemically absorbed and therefore allowed my skin bacteria to recover.

Apart from that episode and sun sensitivity manifesting in quicker sunburn and greater need for sunblock, I had no other side effects from Cipro apart from seeing an occasional rash start in the armpit and then quickly stop when splashed/doused with Zeabsorb AF.

No joint or tendon issues and no issues mixing with booze. I remember during that 6 months I was in Montreal for the Jazz Festival and got totally bombed/smashed drinking all kinds of booze multiple times while taking Cipro with Flagyl.

Scott F reports he has been able to get away with it for 13 years and that might very well continue for him, but if he gets to a point where he needs Entocort to boost things that could be the game-Changer on side effects. It may have been for me.

As far as the toxic effect on the liver, unknown, but didn't effect my liver chemistries like methotrexate did. I asked my GI about long term cipro use back in the late 1990s and he famously quipped to me, "you are the Guinea Pig on that." Well the Guinea Pig made it through 25 years and now I am on Remicade and doing well. I have managed pouchitis for around 27 years overall. Liver has not shut down so far.

Be careful, the HPV warts can always come back.

Last edited by Lauren Of Emerald City

Be careful, the HPV warts can always come back.

They have not come back in over 10 years and it was the only time I ever had a massive attack of them. They were caused by taking high dosages Cipro/Flagyl/Entocort weakening the immune system combined with killing bacteria in the skin, which changes the population balance of micororganisms in the skin.  Since I no longer take antibiotics, it is no longer an issue or concern for me, but the subject of this thread is long term antibiotic use. As explained to me by my dermatologist: taking antibiotics kills bacteria in the skin and when those bacteria die, other micro-organisms like fungi and viruses grow and populate those "empty spaces" left by the dead bacteria.  Which is why ANYONE taking large dosages of antibiotics over the course of time is prone to these things happening (yeast infections and warts).  Although I only had the large outbreak of warts on that one occasion, which my dermatologist said was the worst outbreak of fungal rash/warts he had seen in 30 years, it was not the only occasion on which I had to fight off fungal infections.  I was prone to getting them in my legpits and armpits at higher dosages, and was able to fight all of them off with either Zeabsorb AF or, when they advanced and got bad, Diflucan.

Last edited by CTBarrister

All warts, including hands, feet, and genital, are caused by a virus in the HPV (human papilloma virus) group - there are over 100 strains. Sometimes people think “HPV” refers specifically to strains 6 & 11, which cause genital warts, but this is not accurate.

I recently had an outbreak of 8-10 warts on my hands and feet. They were a nuisance, and the ones on my feet were briefly painful, but they all disappeared mysteriously, as warts often do. I’ve wondered if the immune system activation from the COVID-19 vaccine was helpful in this regard. Certainly the deranged skin flora from my long-term antibiotic use didn’t help.

Scott,

The only other time I ever had a wart, besides the massive breakout I described above in 2010, was a single large wart on the sole of my right foot which developed in 1995 after a vacation to Jamaica and lots of barefoot walking on beaches and wet surfaces. I was taking Cipro back then, but not a high dosage. This wart grew and became quite large and uncomfortable. I visited a podiatrist in Fairfield, CT, where I was living at the time. She initially tried freezing it with liquid nitrogen, which only seemed to superficially affect or impact the wart, which grew again with a vengeance. It actually got even bigger. She then told me that freezing it wasn't going to work, because it was too deeply entrenched and had too good of a blood supply. Actually hearing that it was drawing its own blood supply totally nauseated me.

She then used some powerful acid, which she applied over 2 visits as I recall. The acid was painful and burned. But it did kill that wart.

The only thing I can think of that the wart in 1995 on my foot had in common with the ones I had in my groin area in 2010, besides Cipro, were they all got fed moisture. The one in 1995 developed after walking around public beaches and swimming pools in Negril, Jamaica. The multiple warts I had in 2010 in my groin area, much like the fungal infection that men get called "Jock Itch", came on an area of the male body that can't be kept dry, especially in the summer months.

Anyway, they are mysterious, as far as how they can get big and look like a monster stuck on your body and then they are gone just like that. The ones in my groin area were treated easily with freezing, unlike the one on the right foot in 1995 which had to be killed with acid.

I suspect that antibiotics are causing your warts, but unlike me your immune system is fighting them off without treatment. Which is a good sign, but if they get big or uncomfortable, treat them aggressively as needed. And let a podiatrist or dermatologist do it, they seem to be good at it.

Last edited by CTBarrister

Adam,

There doesn't have to be one cause, it can be a storm of causes, antibiotics, hygiene, moisture issues etc. It's not likely the vaccine as it stimulates an immune response, not immunosuppression. I would stay away from ointments that have water as an ingredient and use an anti fungal powder and keep the area DRY. That means after you shower, take a blow dryer and blow dry your scrotum on the hottest tolerable setting until it's dry and then put on the powder. Keep it DRY DRY DRY

Throwing any ointment that has H20 as an ingredient into your groin area just feeds the fungi. You don't feed bears because you don't want them at your door, and you don't feed fungi for the same reason. Keep em dry and powdered. Zeasorb AF powder is your friend, and if it doesn't work with blow dry hygiene, then call in the heavy artillery, which would be Diflucan. And see a dermatologist for these issues, not a PCP.

Last edited by CTBarrister

Who said anything about sexually transmitted diseases? I think you are making stuff up. Warts are NOT fungal, they are caused by viruses.  ALL WARTS are caused by viruses.  There is no such thing as a fungal wart, and nobody said that there was- except you.  Yeast infections and jock itch and athlete's foot are caused by fungi, and warts are caused by viruses.  The point made above in this thread is that antibiotics (particularly cipro) make you susceptible to infections by both microorganisms, because it kills the bacteria in your skin, opening up living space for other microorganisms. Nobody has any sexually transmitted diseases or fungal warts here.

Last edited by CTBarrister
@CTBarrister posted:

Who said anything about sexually transmitted diseases? I think you are making stuff up. Warts are NOT fungal, they are caused by viruses.  ALL WARTS are caused by viruses.  There is no such thing as a fungal wart, and nobody said that there was- except you.  Yeast infections and jock itch and athlete's foot are caused by fungi, and warts are caused by viruses.  The point made above in this thread is that antibiotics (particularly cipro) make you susceptible to infections by both microorganisms, because it kills the bacteria in your skin, opening up living space for other microorganisms. Nobody has any sexually transmitted diseases or fungal warts here.

You put warts and fungus together, I just misread the comment, there is no need for you to be so disrespectful.

You put warts and fungus together, I just misread the comment, there is no need for you to be so disrespectful.

Your posts were disrespectful.  Go re-read what I posted, I did not "put them together". I said that I had both at the same time, and I said exactly why, and that does not mean warts are caused by fungi or that a yeast infection is caused by viruses. You know that, and you are just posting nonsense as an agenda to try to make people who actually know something about these issues look like they are talking about something else. You posted nonsense on a subject you know nothing about, for no apparent constructive purpose, and a very apparent non-constructive purpose.  Which is par for the course for the vast majority of your posts which disrespect actual science, and the intelligence of many.

Last edited by CTBarrister
@CTBarrister posted:

Your posts were disrespectful.  Go re-read what I posted, I did not "put them together". You posted nonsense on a subject you know nothing about, for no apparent constructive purpose, and a very apparent non-constructive purpose.  Which is par for the course for the vast majority of your posts.

You said you had warts on your genitals, its common to naturally assume STD. And I said I misread your comment. You need to stop being so mean.

You said you had warts on your genitals, its common to naturally assume STD. And I said I misread your comment. You need to stop being so mean.

I said I had warts on my groin area which is a large area.   I did not say I had warts on my genitals, but if I did, so what?  Your posts are total nonsense and frankly you should not even be in this thread because you are hijacking and not helping- which is par for the course on your history here, which is a history of nonsense posting.

How about reading what you are responding to and maybe looking at wikipedia if you do not know what is under discussion?

And if I had an STD you would be the absolute last person in the world I would want to hear from on it.  Please put me on ignore and do me a great favor.  I am not being "mean", I am telling it like it is. Just more of your nonsense: anyone who disagrees with or criticizes your nonsense is either "mean" or a "bully".  Enough.

Last edited by CTBarrister

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