Just a quick question.  First case of pouchitis and going on vacation today.  Just started antibiotic last night.  How soon should I feel better?  I know I saw this addressed before but getting ready to leave soon and have a few things left to do.  Thanks 


Original Post

For many people Cipro works astonishingly quickly, within a day or two. Heck, I started feeling better within hours, and at first I believed I had to be imagining it. For some folks it’s slower or doesn’t work at all. I *think* the discussions of Flagyl have been less surprised by the speed of the response, but it’s tricky to interpret, since many posts just say “antibiotics.”

I hope you have a wonderful, worry-free vacation!

When I first got pouchitis, the antibiotics worked (metronidazole) worked within a day or two.  As the years have gone by they don't seem to work as well and often I end up with C diff. at the end of the first antibiotic.  I have to mention Ibuprofen....since I stopped using it I have not had a pouchitis attack.


Hope your vacation is great!!!


UC  DX in 1998,  J-pouch is 2002.

Scott F posted:

Cipro can predispose some folks to C diff. Flagyl doesn’t work that way, and is even a not-very-effective treatment for C diff. OTOH I’ve been on Cipro for 10 years and haven’t had C diff.

Hi Scott

Have you been on it for 10 years straight? My doctors will never prescribed it for longer than a month at the most.

Maddie, I have essentially been on Cipro for 10 years straight, with some relatively short diversions to try other antibiotics, treat SIBO, and treat a sinus infection. I don’t love being on it, but it’s a thousand times better than pouchitis symptoms. 

Without Cipro I have frequency, urgency, and daytime and nighttime accidents. With Cipro I am essentially normal, active, and healthy, including scuba diving (with long boat rides) and martial arts without any limitations.

I had to add Flagyl to the mix about 5 years ago, but the combination keeps me tuned up, at least for now.

If you can find more than one antibiotic that works it’s better to rotate between them every few weeks. In my case Cipro was the only single antibiotic that did the job.

Thanks for responding.  I started Flagyl last night 500 mg,, 3 times a day.  Feeling so much better, like night and day,  I have a pouchoscopy set up for the 14th.  As long as things go well.  I am hesitant to go on Cipro because I had c-diff twice.  

My understanding from my GI doc is that c. Diff is less common in j-pouchers because that bacteria likes the colon best?

Also, I’d add my experience with antibiotics so far was striking. I was diagnosed with cuffitis and pouchitis, and within 12 hours of starting ciprofloxacin, I felt better. Less urgency, fewer bms, less rectal pain and bleeding. Within a day of stopping, I can feel symptoms returning. I go from 4 bms a day on ciprofloxacin to 8-9 without. Now I’m on a rotating plan, with 2 weeks on ciprofloxacin, 2 weeks on vancomycin. The vancomycin isn’t nearly as effective for me. 

So my scope found no inflammation or ulcers- no pouchitis.  A good thing for sure.  I haven’t got results from biopsy yet, but things looked good.  Not sure why I responded so well to Flagyl.  The only other thing I can figure out is I had been on a short course of antibiotics for dental and it threw off my gut.  Waiting to discuss this with my surgeon.  Any thoughts?

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