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Is it standard to treat a (not so certain) case of pouchitis with two weeks of both Ciprofloxacin and Metronidazole? It seems like over kill. I thought Cipro alone was the go-to for a one time bout.  I'm not even convinced this is pouchitis although there is increased frequency, increased gas and some nightly incontinence which I've never had before.

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Some docs seem to go directly to two antibiotics. They probably do get better rates of clearing it up in one go, but 1) there will be more medication side effects, and 2) if there are unacceptable side effects you may not be able to easily tell which medication is causing them.

FWIW, your symptoms sure sound like pouchitis to me.

@Ezzy posted:

Are biologics being prescribed for pouchitis these days? what about if there are ulcers in the pouch as well

Biologics wouldn’t be used for an “ordinary” bout of acute pouchitis. 10-14 days of antibiotic treatment is usually used for that. Biologics are used for chronic pouchitis when antibiotics don’t work or when the provider judges (for one reason or another) that antibiotics have become problematic. Ulcers are just a symptom of uncontrolled pouchitis.

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