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I have an overgrowth of bacteria and have had reoccurring symptoms of pouchitis in the past, for which I take 500 mg of Cipro. I’ve recently had random muscle pain in my leg/calf and my rheumatologist (I had arthritis as well) said she can’t identify what the cause is. She really thinks it could be related to the Cipro.

My gastro says I could swap and take Vacomyacin, which I’ve taken in the past for c-diff, and it was not the best experience. It left me with a horrible taste and made food taste horrible. But, if my calf pain is caused by my cipro, then why not try the vanco again? I guess I’m wondering what others’ experiences are and if they have taken other meds for pouchitis that have been helpful besides these two.

In addition, I’m also reading these horror stories online about cipro of those having muscle issues even after they stop cipro. How do I even know if that’s what’s causing my pain/side effect? The only thing I can think of is to stop it and try something new. Taper off Cipro?

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The most commonly used alternative to Cipro for pouchitis is Flagyl. Have you ever tried that? OTOH Flagyl sometimes causes a metallic taste, though I tolerate it fine. For SIBO I took doxycycline, though others have reported using rifaximin (Xifaxan), which also is used in pouchitis with perhaps the fewest side effects.

Actually I think I did take a flaygl before- I tried that before i ended up going to vancomyacin bc the flagyl didn’t work (c diff was difficult to kick). Maybe that’s the one hat I remember tasting horrible- I was missing up the side effects up in my head/memories. So you think the side effects are less with the flagyl? Is it better long term? Maybe worth another convo with the doc.

Last edited by Bubba1028
@Bubba1028 posted:

Actually I think I did take a flaygl before- I tried that before i ended up going to vancomyacin bc the flagyl didn’t work (c diff was difficult to kick). Maybe that’s the one hat I remember tasting horrible- I was missing up the side effects up in my head/memories. So you think the side effects are less with the flagyl? Is it better long term? Maybe worth another convo with the doc.

The side effect are certainly different between Flagyl (metronidazole) and Cipro. Cipro can sometimes cause serious tendon problems, and that could sure feel like muscle problems (I’ve been on Cipro without a problem for 13 years, but I do know someone who’s had life-threatening side effects). Other than the taste issue, Flagyl seems to sometimes cause peripheral neuropathy (finger tingling/numbness) that can sometimes be permanent (I’ve been on Flagyl without a problem for 7 years). And almost all drugs seem to have some very-rare-but-terrible side effects. The safest one in the bunch is rifaximin, but it didn’t work for me (and is very expensive). The best one for *you* is the one that does the job without much unpleasantness, which is a trial and error problem.

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