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My husband had an endoscopy last week and was diagnosed with pouchitis and mild pouch ulcers. They prescribed Flagyl, which he can barely tolerate for a week at a time. He's supposed to be on it for a month straight. Does anyone else do pulse therapy with Flagyl and had it be effective? He can't take Cipro, he's allergic.

I ordered him Visbiome yesterday, it should come next week. (And THANK YOU to the folks in this group who clarified the VSL#3 / Visbiome confusion). His doc wants him to start on it after the Flagyl. He had been taking VSL#3 on a pretty regular basis but he ran out and didn't replenish. I'm wondering if it would work to do one week Flagyl followed by one week Visbiome as the pulses. If anyone has tried this, I'd love to hear your experience.

He was also prescribed a mesalamine suppository, but even with insurance the pharmacy (Kinney) quoted us about $500. Does anyone have hints on getting this cheaper? We're in the US (New York state).

This is not even close to our first rodeo with pouchitis, and I'm sure it won't be our last but I'd like to help him feel better soon! He's been feeling miserable the last few weeks :-(

Thanks very much, I'm so grateful to have this group to navigate the murky waters of pouchitis and UC, etc. !

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Although I am not optimistic about that treatment regimen, it was suggested to me in the past. For me, cipro and flagyl was the best tandem and Visbiome or VSL#3 as it was formerly known never did a thing and I got worse while on it. I was also on mesalamine suppositories and enemas. Both were completely ineffective.

I think your husband is probably right where I was in around the year 2000. Eventually there will be too many pouchitis rodeos, there will not be a permanent fix and biologics will be suggested. I of course hope that's not the case, but it's possible as a large number of chronic pouchitis folks end up on biologics. I have been on Remicade since 2015 with very good results. Pouchitis was mostly eliminated with some persistent inflammation at the J pouch inlet from backsplash stool. If at some point your husband isn't happy with the results of antibiotics and probiotics, biologics are the next line of treatment. For me, Remicade has been far more effective than antibiotics and probiotics.

Last edited by CTBarrister

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