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J Pouch Issues: Anyone have problems due to aging of the pouch?
I had a colectomy in 2000 with a temporary ostomy and then a J Pouch placement. I love the freedom of it. For the most part, my J pouch has been pretty good with periodic bouts of pouchitis through the years. Now that I am 75 years old, I am noticing increased problems i.e. a number of food sensitivities I never had before, increased periods of fecal incontinence at night. I did some research and found that this may due to the aging of my pouch.
I am now struggling with a bout of pouchitis. I am trying to avoid Flagyl since the side effects are quite rough. I was prescribed Xifaxan and am finding it takes quite a number of days before getting any relief. Consequently, I am now reconsidering Flagyl since the Xifaxan, thus far, does not seem to be as effective in ridding me of the significant pouchitis discomfort. I have read some posts of people who elected to remove their pouch. The thought of losing it is a very stressful one for me and something I do not want to consider.
I have joined this group, hoping to find others with a J Pouch and related challenges. Hopefully we can be a support to one another.
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@equanimous I had chronic pouchitis for 15 years, and it was kept under control with a combination of Cipro and Flagyl.
It seems plausible that a course of Flagyl may get your your pouchitis under control. Because you don't have a chronic case that might be all you need. I would recommend talking to your GI doctor.
The biggest side effect of Flagyl that I noticed was a metallic mouth taste, and of course you can't drink any alcohol at all while you are on it. I don't appear to have any long-term effects from it, and I was on it for 15 years.
Why did you have the colectomy?
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1 ReactionI was on a cipro/flagyl rotation for years, & have some of the side effects that go along with that. I was switched to Tremfya in August of 2025 and in April I had a scope and was told I had severe pouchitis so my GI added vancomycin instead of the cipro/flagyl. I have had my pouch for 30 years and also have nocturnal leakage, so not sure if it is due to the inflammation or if it is just the age of my pouch and that area. I am still trying to figure out something, as I really don't want to get rid of my pouch either unless it is the last resort. Best of luck to you and I hope you find some relief.
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1 ReactionFlagyl always works for me but recently I had salmonella poisoning and am on Cipro now for the first time.
I had my experimental surgery in 1986 before the regular J-Pouch was adopted as preferred. Now at 73 things had been quite well until 2 yrs ago when I started to have a few problems. But I am still very happy with the results. If you are on the Mayo site that means you have the best team in the world working towards your best health possible.
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2 Reactions@equanimous, I hope you saw the helpful responses from @susanf8 @janspons and @mitchmyers. Have you decided to try Flagyl? How are you doing?
@colleenyoung Hi Coleen, I am not doing too well. I wrote my dr on the 9th day of Xifaxan saying that my symptoms have not improved. I was told to I hang in there with the Xifaxan which I did. I had a few day improvement but I am still experiencing nocturnal incontinence. To make things worse, I just realized I was given half the amount (14 days) of Xifaxan opposed to 28 days. There were so many pills in the bottle, I did not think to count them. I finished the 14-day Rx a few days ago. Still incontinence. My GI dr has been on vacation and I now am waiting for a response as to what I should do. This is so frustrating! I miss my GI dr who I had for over 20 years. He retired and I am now faced with a dr who is a lot less responsive. Meanwhile, my pouch is still inflamed and I wake each night with a mess to clean up. I never thought I'd be looking forward to taking Flagyl but it seems like it may be the best for clearing this up. I guess this is a good opportunity to exercise patience (which I have very little of!). Thanks for your message. I hope you are well.
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1 Reaction@mitchmyers, how are you doing on ciprofloxacin?
@colleenyoung
I cannot take Cipro. I had a very bad reaction a few years ago and they immediately discontinued it. I sure wish I could but I can't.
@colleenyoung
The citronella worked fine to clear up the food poisoning. I still get intermittent sharp pains in my mid-abdomen throughout the day but better than before.
@equanimous checking in. How are you doing?