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Another way to tackle this is to control your periods if they truly are the source of your flares. Sounds like it is the case since you say it occurs every time. You can go on birth control pills, the patch, Norplant, etc.. Seems like a better choice than antibiotics (if it works). A number of women here have gone that route. Probably easier to get into a GYN appointment than GI.
Prostaglandins released during periods affect you and make you poop. Even "normal" women are affected. See this site:
She doesn't get "period pain" or cramping worse than a normal woman, what she does get is extreme bowel issues. I still think there could be a hormonal connection.
This is why I suggested seeing your GYN. GIs aren't accustomed to prescribing birth control pills. Out of their league. But, your GYN should be familiar with GI effects of menses.
I can definitely empathize with you. I usually have about 3 days a month (typically 2 days before and 1st day of period) where it feels like my pouchitis is spiraling out of control and that I feel like I have the flu. I can't tell you how many times I go to reach for my bottle of antibiotics ready to rotate or increase my dosage, when I stop, look at the calendar, and decide to wait a couple days. This happens to me every month. I agree with what others are saying regarding possible birth control to help calm this. My GYN has been pushing me for years to take something to make my periods better and hopefully help with the pouch issues around this time, but I've refused as I hate the idea of more meds! So, I deal with it each month, and it sucks :-/
I tried to wait out this month....five days in I couldn't deal anymore. By second dose of flagyl I was feeling better BUT I noticed my period was ending. I may look into OCP but the point of the hubs getting a vasectomy was so I wouldn't need birth control. A doc I know who is a poucher got a mirena and said it made her worse. Oh, make a plan watch God laugh....does anyone take vsl and have improvement? The whole microbiota theory. Ps-thanks to everyone who has helped with responses now and in the past. I wouldn't have made it so mentally intact, however tenuous it has been at times. I need to reread some research. I did find some stuff on PubMed regarding sex hormones IBD and IBS. Both reiterating what Jan and Rachel stated. Found a case review on IBD or that took DHEA with resolution of symptoms while she was on it.
Copper IUD made me bleed for 2 weeks straight. Could never get it to chill/regulate. Ended up iron deficiency anemic.
But low dose BCP helps so much. My ovulation pain is *killer* it's so bad, especially on the left. I can't even bear down to poop, hurts so bad, for about 3-4 days. Hurts even down my IT band there, can barely walk when it would happen. Pouch gets crazy, vacillating even to constipation, just feel like I want to sit on the toilet constantly. And that's ovulation for me without BCP! My gyn nurse who is super said it's probably because I'm older (44), these are likely my last ditch wonky eggs trying hard, plus lots of scar tissue. I only one other time in my life was on BCP, when I got married, for about 2ish years. Never thought I'd be on stuff again, as my cycles were easy-peasey, til recent times.
At this point, I would say your best option is talking with someone in the gyne world about controlling your periods, in some way, shape, or form, whatever the safest way would be for you. Since it correlates with your monthly period, it seems obvious that your gyne system is to blame and is the catalyst vs your pouch being the real issue. I would seriously find a sympathetic gynecologist or NP who can guide you better. A GI doc may not be the best expert in this area.
So sorry for all of the period related pouch trouble...
I've had my k pouch since the age of 18 (54 now) so most of my adult life...and I've had a very physically active life.
I used to feel as if my pouch was going to explode and my uterus was going to fall out my bottom...it felt so heavy and painful...cramps were legendary...my pouch ran like water and I developed a lot of ovarian cysts.
In the end after surgery to remove the cysts and open up my fallopian tubes (they were blocked...one with an ectopic pregnancy which they say is more common with us for some unknown reason) they put me on progesterone for 3 yrs to stop my periods and put my ovaries to 'sleep' (to avoid the creation of more cysts)...when I got my periods back they seemed lighter and less painful.
Their only suggestion to us girls was to control our periods by going on the pill or suspending our periods outright...
Sorry for no miracle solutions...diet does help a bit thought...although I was never a carb eater I found that mashed potatoes with olive oil seemed to calm my pouch down.