after suffering side effects from Flagyl (peripheral neuropathy), and Cipro (torn and damaged tendons in shoulder and calf), my wife (ex nurse) suggested topical application of those drugs, directly into the pouch. It works! Two weeks of one drug then swap over for two weeks on the other. Just 250 mg in 250 ml water, use an enema bag to insert into the pouch after emptying the pouch in the am and pm.



Original Post

I’d suggest great care. You may be absorbing just as much medication through this route, and be exposed to the same side effects. 

The oral dosage that caused my side effects was 500 mg times two or three times per day. (The dosage varied with change in my Dr.)

Pouchoscopies had shown that the inflammation was only in the pouch, the descending small bowel was perfectly normal.

The dosage used topically is only 250 mg once per day, so even if some of the drug is absorbed through the lining of the pouch, the dosage is 1/4 to 1/6 th of the oral dosage. And the absorption is much less than what happens when taken orally. No side affects like bad taste in mouth, and the annabuse effect of flagyl. So I can enjoy a few beers, or glasses of wine, or single malt scotch.

Great! My concern was that peripheral neuropathy is generally grounds for immediate discontinuation of the medication. I’d recommend careful monitoring for any worsening, just in case.

Hi everyone I just got home two days ago doing allot better I had the pouchitis  for a week now I can say it sure is a mess to go though I would suggest any going in hospital know they going to get treaded to have a case of Thier own dippers I order mine from Amazon but if you use thier cheap dippers they will fall off  of you and make a mess the prevails are great for incontanace problem s I doing better but  with this pouchitis hitting be so hard I ordered two cases I asked the VA if they provided dippers but I'm not sure there as good as prevail brand these really hold up for adults I have slowed the flow down by using canasa supositories but I didn't know you only use one at night at bed time on the boxes it sead to take two I uses three in on day when I first got the pouchitis and got the side effects the butt burn and  nausea

Thanks Scott for your concern - we continue to monitor my condition. Rifaximin will not be absorbed through the pouch lining, but it is too expensive a drug. A single prescription here costs over $1,000. The reason for my post was to help others who are suffering from pouchitis and trying to remedy the condition with lomotil or Imodium. These only slow the gut down, but do not relieve the inflammation.

I believe that was a great idea the next time I get pouchitis I think As I feel it coming on is to get a CBC blood test to see the level of infection then if I need hospital attention I bring that idea up the IV meds was a terrible fush incident

This is really interesting, thanks for posting. I really do believe that an enema is the most logical way to address pouchitis. 

Johnnycomelately, I’m intrigued by the idea of antibiotic enema.  Do you simply dissolve the pill into water?  Also why have you switched to hydrogen peroxide?  Did the antibiotic enemas stop working?  When I searched online hydrogen peroxide enemas had tons of warnings against using.


Doffodilly, yes, both cipro and flagyl will dissolve in water. Since I have experienced bad side effects to both of these drugs, I am trying to find a treatment that limits the use of these drugs. The pouch is part of the small intestine, so some of the drugs do pass into my body.

I am taking great care in the use of hydrogen peroxide, very pure and low concentration. I am reporting my progress with my gastroenterologist, and expect to be seeing her soon for my annual checkup.

I took H2O2 orally for around 6 months for arthritis and it really helped, however I don't think it helped my pouchitis. Colloidal silver will be much more effective, especially as an enema. There is a guy on the forums called Ceth who made an amazing post how he controls his pouchitis through CS enemas.

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