Post Surgical Flare... Any Ideas?

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Joefnh
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Post Surgical Flare... Any Ideas?

Post by Joefnh »

The surgery is done and I'm feeling pretty good as far as any pain. One thing that has kicked in with a vengeance is D, most likely from all of the antibiotics I have been taking which include cipro, flagyl and avenox. I am on day 7 of them and have D about 10x a day.... My diet has been a very strict GF DF SF mix of vey soft simple overcooked foods to give the GI tract an easy time of it for a couple of weeks.

The question is with this type of onslaught from the antibiotics, what would be the best way to settle this down? I would think a probiotic would be beneficial but it has been noted noted I think by the members here to be of limited value.

I know that cipro is one of the more MC friendly antibiotics, but I am not sure of flagyl or avenox.

Joe
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MBombardier
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Post by MBombardier »

Oh, man... !! :sad:
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Post by Zizzle »

Yikes, have you tried immodium yet to slow things down? Pepto? I'm still on the fence about probiotics for everyday MC management, but maybe this is a good time to try and repopulate some good bacteria? Any chance this could be hospital acquired C-diff? You might consider submitting a stool sample for culture. Does your doctor know?
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Joefnh
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Post by Joefnh »

Hello Marliss and thanks for the reply.

Hi Zizzle, I have not tried anything yet. I was thinking of trying some of the questran that I have but am cautious as questran can interfere in how other meds are absorbed if not timed right. I believe with questran if any meds are taken within about 3 hours of a dose, then the other may not be absorbed.

That's a good question about cdiff but given all of the antibiotics I am on is it possible to have cdiff?

Joe
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Jan
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Post by Jan »

Joe,

When I had my colonscopy I took a probiotic for about a week just to rebuild my system up. With all the antibiotics that has flooded your system, it might not hurt. I know there are mixed reviews on them. The one I use (as recommended by my GI is FloraQ. I had to order it. I couldn't find anyone who carried it locally.

Jan
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Post by nancyl »

Joe,
I was wondering if all those antibiotics would cause a problem. I am sorry that it did.
I do think probiotics help and a good one that my nutritionist highly recommends and also at the health food store in West Concord is
Bio-K. It is a liquid sort of like a yogurt. It is DF. They feel because it's liquid it gets right into the system a lot quicker. You can only get it at a health food store. I got the mango flavor with I was in a bad flare.

I hope you start feeling better. Keep us posted.

Nancy
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Post by JLH »

I got FloraQ at our local CVS. PRICEY but worth it.

Get well soon, Joe.
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Post by fudette »

After my recent surgery my dr. had prescribed avelox for 10 days post surgery. I was fine for about a week and then the d started up again - not as bad as it used to be - only about 6x a day (funny how I can say "only"!). I called my GI and he had me take florastor and I'm feeling much better now after about 5 days of it with only some slighly loose d in the am.

Hope you're starting to feel better!

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Zizzle
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Post by Zizzle »

Joe,
I think C-diff is a possibility because it's resistant to most antibiotics. That's why you get it after taking antibiotics. It's no longer crowded out by other bacteria and can really proliferate in an otherwise bacteria-void gut. Can't hurt to tell your doc and send a sample for culture. Extended hospital stays are also associated with C-diff.

I've heard decent reviews of dairy-free Culturelle and VSL3 for probiotics. I've tried the Culturelle, but very sporadically.

Hang in there!

:flush:
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Post by sarkin »

Joe,

Many years ago, I took Flagyl *for* a C-diff infection - and my mother did as well, years later. So if that is an issue, it's possible that you're already fixing that problem. I sure hope it's not C-diff. Gosh, I hated Flagyl - hope it's sitting better with you.

The brand Mega-Food makes a pro-biotic that I like. It is emphatically DF/GF/SF - I don't honestly know that I can tell whether it helped. For sure, when my mother had recurrent C-diff, the brand with 'Pearls' in the name was useless, but both the Mega Foods and New Chapter brands seemed to help.

I am sorry you're flaring - truly hope this flare will be very brief and you can concentrate on the important work of recovering.

Love,
Sara
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Post by mbeezie »

Hi Joe,

Sounds like you need to call your doctor - getting checked for C-Diff is a good idea. Also, while some strains of probiotics (like s boulardi) might be of benefit, people with Crohn's need to be extra cautious about their use because of the risk of bacterial translocation. However, the high dose antibiotic you are on might just kill off any benefit for now.

Bummer about the flare - here's hoping it's short lived.

Mary Beth
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tex
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Post by tex »

Hi Joe,

Sorry about the flare. :sigh: It's always something.

While C. diff is certainly a possibility, it's not likely to be your problem, since Flagyl is a C. diff treatment. Of course, antibiotic-resistant strains are resistant to Flagyl, and have to be treated with Vancomycin. Still, even if Flagyl is unable to destroy an existing infection due to resistance, it should have prevented an infection from developing, (I'm pretty sure that's why you're taking it, in the first place, as a precaution against a C. diff infection).

Ciprofloxacin almost never causes D for anyone here on this board, so the blame almost surely goes to the avenox, which, as you probably know, is a treatment for recurring forms of multiple schlerosis. I have no idea why you're taking it, but I'm sure there is a reason. Avenox apparently works to prevent MS flares by preventing damage to the myelin sheaths of nerves. I'm not sure how that ties in with your treatment program.

Frankly, I don't see how a probiotic could help to prevent D, as long as you're taking an antibiotic, because virtually any antibiotic is going to easily kill all the probiotic bacteria, pronto.

Ciprofloxacin will normally stop an MC flare very quickly, without any other intervention, so whatever is causing your D, constitutes a pretty potent effect. The "short-bowel" effect shouldn't be an issue with the removal of a short section of the jejunum. If a section of your colon had been removed, it would be a different story, of course. Anyway, the point is, the D is probably not due to the surgery, but to something that you are doing now, and the avenox injections would be my my main suspect, FWIW.

I hope it resolves soon,
Tex
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Post by Joefnh »

Thanks for all the replies and the advice. I did call my GI doc and he said if this continues into next week or gets worse that he will have a sample tested.

I tend to agree that probiotics probably would do little good until the course of treatments has been stopped. but I may try introducing them slowly after the antibiotics have been completed. MB can you describe what you were talking about in reference to the Crohns and antibiotics?

Tex I misspelled 'avenox', it's actually avelox which is an antibiotic

" Avelox (moxifloxacin) is an antibiotic in a group of drugs called fluoroquinolones (flor-o-KWIN-o-lones). Moxifloxacin fights bacteria in the body."

I should also say I did not notice this flare as the narcotics had been surpressing the D, once I stopped taking the pain killers things started up pretty quickly yesterday.

Thanks again

Joe
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tex
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Post by tex »

Joe wrote:Tex I misspelled 'avenox', it's actually avelox which is an antibiotic
Ah yes, spelling does matter, sometimes. :lol: Well, that explains why you were taking it, anyway. Any of the fluoroquinolones should help to prevent D, just as well as Ciprofloxacinm, so that deepens the mistery of why you are having D. :headscratch:

Narcotics are notorious for causing constipation, so you may have had this since they restarted your digestive system, a day or two after the surgery. If I were in your shoes, (and assuming that I could tolerate it, which I can't, because even half a tablet makes me dizzy), I would try to see how much Imodium it might take to do the trick. IOW, this is guessing that the D might just be a holdover effect from the shock/stress of the surgery to your GI system, and it just needs something to slow it down a bit, so that it can settle back down to normal operation. :shrug:

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by ant »

Dear Joe,

Thinking of you. You really have been going through a rough time these past days. I hope the flare can be brought under control soon.

Best wishes, ant
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