Hello all! I have had my pouch about 15 years. I had my first bout with pouchitis in February and every month since. My question for now (more to come I’m sure) is how long before a doctor will move on to another treatment such as biologics? How long did you stay on antibiotics before trying something else?
It depends on your scopes. If the antibiotics are not reasonably keeping inflammation in check, you get moved on to biologics quickly. When is your next scope?
I was put on Remicade and it cleared up almost all of the inflammation I have in my J Pouch. My only issues now are scattered ulcerations at the J Pouch inlet and the rectal cuff, which are areas of inflammation which are traditionally more resistant to treatment. My Gi doc is pleased with how the Pouch looks.
By the way, I was on antibiotics for 20 years before going on Remicade in 2015. Remicade did not exist back when I started on antibiotics. But I was scoped annually and my scopes by 2015 were showing that the antibiotics, which previously had been keeping the inflammation in a "simmering" state, no longer were and it was becoming moderate. At that point my GI Docs, both my former one who went to NYC to pursue a job offer there, and my new one as of 2015, recommended biologics.
You need to be scoped regularly to determine the efficacy of treatment.