Sulfasalazine as alternative for chronic pouchitis

I have no idea what "too much Cipro" means, but you have two different questions here: 1) do you have chronic (antibiotic-dependent) pouchitis?, and 2) will sulfasalazine control it? Starting sulfasalazine immediately will answer both questions if it fails, but only one question (in a fuzzy way) if it goes well. If I were in your situation I'd first want a clear answer to question 1.

It's possible your doctor is exploring whether sulfasalazine is good enough to prevent pouchitis recurrence (a bit like VSL #3's behavior), but not whether it can treat an acute episode. This is a reasonable idea to try, but it will still be hard to know what's going on if the sulfasalazine works for you.

Sulfasalazine isn't commonly used for plain old pouchitis, but it's a reasonable drug for cuffitis. Your doctor might have reason for some uncertainty along those lines, too.

When I had my colon and had my first major flare. 

Sulfasalazine put it in remission for 10 years.  

It was unreal.  A cheap pill.  Remission.  I forgot I even had UC. 

Now using it for something else.  Scott.  You seem well informed on these matters. 

Is Sulfasalazine an antibiotic?  This was decades ago. 

I suppose I could look it up.  But if you post here all will know. 

Richard. 

Sulfasalazine isn't an antibiotic. Its exact mechanism of action for IBD isn't known.

Thanks Scott.  I just know it worked for awhile. 

Richard. 

Scott F posted:

I have no idea what "too much Cipro" means, but you have two different questions here: 1) do you have chronic (antibiotic-dependent) pouchitis?, and 2) will sulfasalazine control it? Starting sulfasalazine immediately will answer both questions if it fails, but only one question (in a fuzzy way) if it goes well. If I were in your situation I'd first want a clear answer to question 1.

It's possible your doctor is exploring whether sulfasalazine is good enough to prevent pouchitis recurrence (a bit like VSL #3's behavior), but not whether it can treat an acute episode. This is a reasonable idea to try, but it will still be hard to know what's going on if the sulfasalazine works for you.

Sulfasalazine isn't commonly used for plain old pouchitis, but it's a reasonable drug for cuffitis. Your doctor might have reason for some uncertainty along those lines, too.

Too much Cipro, to me, means I take a two week course and  the symptoms return very quickly, and I'm on it again a week or so later. I agree that it would be critical to know if I have chronic pouchitis, of course, but I had an ongoing issue with a stricture in the connection of the j-pouch and my anus. I am past that, now, I hope, by self-dilating with an 18mm Hegar Utrine dilator, twice week, at this point. So, it remains to be seen if now that I am keeping the stricture open if I'll keep getting pouchitis.

Sulfasalazine worked for quite a while for me for cuffitis and pouchitis. But, eventually I needed chronic antibiotics. I am now on Remicade in addition to sulfasalazine, which is working well. However, Remicade isn't working as well for my arthritis. 

Jan

Thanks you, Jan. I hadn't heard about Remicade before, but will remember it if it is needed to be aded to Sulfasalazine. Still hoping the the self-dilation will do away with pouchitis infections effectively.

I've been on antibiotics for many years (10 now!) for chronic pouchitis and was recently put on Lailda (another form of mesalamine) for some cuff related issues. It seems like it is helping my pouch too. I am still on antibiotics as well, but my pouch seems better than it has been in a long time. I'm wondering if it is the Lialda making a difference for some reason. I'll get scoped again in a few months then we'll see how things look. 

Thanks for the info. I see the it is in the same family as Azacol, which I used to take when i had colitis, before my J-pouch operation.  I'll put it on my list for my doc to consider if I have  persistent pouchitis.