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I think I may have pouchitis, but unsure. 3 or 4 days ago I started to have very watery movements, like I would just dump water out of my pouch. Then the next 1-2 would be normal, then water again, very yellow and mostly odorless.  A couple days before this started i tried a new probiotic call l.rueteri, so and I’m hoping that is unrelated since I only took 2 pills before stopping. It may be related to dehydration which I’m constantly battling.  On wed i accidentally drank a cold brew coffee instead of the usual 1 a day iced coffee in the morning which I tolerate well and keeps things moving nicely. Cold brew has literally sent me to the ER for dehydration in the past. Yesterday I started having some cramps in my back while mowing the lawn and then started a dull ache/burn in my pouch as well as a headache, shivers low back ache. I’ve had this before (but never with light shivers or low back ache) and can usually get it to resolve with changes to my diet and routine.  I upped my Imodium from 3 to 4 per day and have increased my psyllium m, florastor, culturelle and vsl#3 doses. This seems to have controlled the water dumps from my pouch and I have been going crazy trying to rehydrate, been drinking electrolyte water all day, slowly and now I’m peeing clear every hour. I’ve had similar pouch ache in the past but this time some chills and well and low back ache, dizziness. I called my GI and got his parther who says I have pouchitis. He was super short with me on the phone and basically insisted that I have pouchitis. He wanted to put me on Cipro or flagyl but both are a no go for me. Major side effects to both. I suggested augmentin which I’ve taken for sinus infections and although it makes me a bit nauseous as a side effect it improved my pouch function—I’m going on 9 years with my pouch and have mostly been in the best health of my life. 2 years ago I got a bad digestive infection which literally almost killed me in the South Pacific and started a roller coaster ride with antibiotics, levaquin and Cipro, which I can no longer take due to skin rash and neuropathy, then chronic sinus infections, staph infections, UC in my lungs all triggered by the combo of Cipro and levaquin. I’ve been off all antibiotics for 8 months now and felt great until 4 days ago. Needless to say I’m terrified of antibiotics. I took one pill of augmentin this am but now I think maybe it was premature. I actually feel a lot better mostly from rehydrating I think, however. Is it reasonable to stop the augmentin and give it another day or 2 to see if I keep improving since I only took a single pill? I’d rather not do the full 14 days if I don’t have to since antibiotics always seem to start a downward spiral for me. I actually believe excessive antibiotic use for acne as a teenager triggered my first UC flare. If I don’t continue to improve I would restart the augmentin on Monday when I can speak to my actual GI. Stopping after one pill isn’t the end of the world right? Bacteria resistance isn’t that fast is it? Does this sound like it could resolve with a more conservative approach?

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You might just have a viral infection that will clear up on its own, whether you treat it or not. That’s actually what it sounds like to me. Of the things you changed I’d guess the psyllium probably made the biggest difference. One antibiotic dose won’t cause bacterial resistance, so it’s kind of a coin toss whether to continue the antibiotic (presuming pouchitis) or to stop it (presuming something that will clear up on its own). You had some bad side effects to two very similar antibiotics (Cipro and Levaquin), but that really doesn’t say as much about other antibiotics as you seem to suggest (the Augmentin was a good idea, IMO). Whatever you decide, I hope you feel better soon.

My pouch function is much better today! I decided to wait on the Augmentin after that one dose. I also upped my VSL#3. No more body aches etc. what’s lingering is a dull ache in my belly actually towards the front which I think must be my bladder or prostate. It seems to far forward to be my pouch. I doubt I have a UTI. No pain or urgency to pee. I’ve been drinking a TON to rehydrate and peeing like crazy. So I wonder if I inflamed things? Could an inflamed pouch push against the bladder? I’ve def had this feeling before and it isusallu resolves on its own. A little more intense this time.

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