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Antibiotics for UC

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Ulcerative Colitis
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Posted 3/22/2017 7:34 PM (GMT 0)
Hi All! I would like to hear your view on antibiotics.

I have UC and have been flaring on and off since last Summer. I do not get too many BMs per day (my all time high is one day that I had 7, but otherwise on average 3 when I am flaring and 1-2 when not flaring).

For me the key sign of a flare is blood - otherwise I have no real urgency, pains, malaise etc... i.e. my life goes on almost normally, except for the bright red blood I get on the paper and sometimes in the water too. The amount of blood varies but ranges from a few stripes on the paper to several drops which taint make the water red.

I am taking Asacol 5x day and Pentasa enemas every night (when in a flare); when I am fine I only take Asacol 3x day.

Over the past year what has gotten me completely out of a flare was Flagyl; I have used it three times recently, once in August for 10 days, and once in December for 10 days and one in February for 11 days.

I am now flaring again and was wondering whether I should take antibiotics again. I would, but I am just scared that taking them too often would have serious side effects and/or decrease their effectiveness.

How often have you taken antibiotics over a year, and for how many days in a row?

Also this time I decided that before I take antibiotics again, I will try to go on an elemental diet for 10 days give my colon a rest. I have read it works wonders for some people, so I might as well give it a try.
Posted 3/22/2017 8:49 PM (GMT 0)
i've read that rifaxan has helped many people, but i have never tried it. You should read the Hailey's protocol, very interesting. Hope she will update us soon
Posted 3/22/2017 9:02 PM (GMT 0)
Flagyl helps a lot of people. If it helped me, I would have taken it more often. My problem is that antibiotics offset my flora balance and cause other issues - that and the fact that it wasn't any great slam-dunk for me made it pointless...

Does your GI keep writing the prescription for the antibiotics? If so, you should consult with them to see whether your concerns are realistic. December & Feb is quite close in time. Perhaps you should stay on that higher dose of Asacol and use rectals nightly. Your GI should really give you some ideas of what to do.
Posted 3/23/2017 4:27 AM (GMT 0)
I'm currently on Cipro and Flagyl and am doing the best I ever have since I got UC. My sedrate is down, blood has disappeared, frequency is down to maybe 3 times a day from 15 last fall. I am not in remission though and wonder if that will even happen. In my opinion it's worth a shot.
Posted 3/23/2017 1:35 PM (GMT 0)
@notsosicklygirl: you mean that antibiotics was not very effective in your case? Also if I can ask, you are referring to "other issues" that antibiotics were creating - what were these?

@desertfox313: how long have you been on cipro and flagyl for? How often have you taken antibiotics over the past year, and have they been equally effective all of the time?
Posted 3/23/2017 1:48 PM (GMT 0)
if you have been on them 3 times in one year, then they don't seem to have fixed anything - for some they do -

i would avoid taking them again -

also, if you are continuing to flare, try sticking with the max dosage of asacol for at least a year before reducing -

what have you done as far as diet changes ? if you are going to do a bowel rest, i would suggest more of an elimination diet -
Posted 3/23/2017 2:07 PM (GMT 0)
makes sense - the remission that antibiotics brought was not permanent, but they definitely helped me out of a flare. I then wasted the "opportunity" by eating and drinking badly, but now I understood how important diet is.

I have been on a very low carb diet (GAPS/SCD) for the past 2 weeks and this has helped: the only symptom I have is a few drops of fresh blood on the paper after 1-2 BMs per day, but it is still annoying to see and definitely doesn't mean remission for me!
Posted 3/23/2017 2:14 PM (GMT 0)
What about if you did the enemas twice a week when not flaring
Posted 3/23/2017 3:27 PM (GMT 0)
Let's talk about the fact that antibiotics kill bacteria. Which means that anyone who benefits from taking antibiotics obviously has some bad bacteria present in their system which, when killed, alleviates their symptoms. Which means that the cause of their symptoms wasn't UC, but rather bacteria....
Posted 3/23/2017 3:42 PM (GMT 0)
UC is the consequence of our immune's system reaction to an overgrowth of pathogen bacterias in our colon - this seems to be a fairly general view in scientific literature. A great book on the topic is "Inflammatory Bowel Disease: The essential guide to controlling Crohn's Disease, Colitis and Other IBDs" by professor John Hunter.

The problem is: what bacteria trigger the immune reaction.

Some scientists point to sulphate reducing bacteria; see for example this interesting study:
https://www.ncbi.nlm.nih.gov/pubmed/23898195


In fact, other studies show that the reason why some diets work with UC is because they affect the metabolism of these bacteria - see for example this study, where they point at red meat, eggs and proteins as potential sources for "food" for these bacteria:
https://www.ncbi.nlm.nih.gov/pubmed/15361498


In general however, the scientific community cannot agree on what bacteria specifically causes the immune system reaction. Note that in UC sufferers, the immune system reaction is "too strong" because of genetic characteristics of us poor UC patients: basically, our immune system has some "defects" causing it to over-react to the presence of these bacteria (that are also present in healthy individuals).

This is one of the reasons why for some UC sufferers find that low-dose naltrexone has a very positive impact on their illness: this is because this alternative drug restores the normal mechanics of the immune system reaction by blocking opioid receptors during the night triggering an increase in endorphin and encephalin production.

Long story short, antibiotics are often effective with UC because they kill ALL bacteria in the bowel (good and bad), but by doing so they switch off the reaction of our damaged immune system to it.
Posted 3/23/2017 6:17 PM (GMT 0)

the OP said...
For me the key sign of a flare is blood - otherwise I have no real urgency, pains, malaise etc... i.e. my life goes on almost normally, except for the bright red blood I get on the paper


If you have formed stools with the only other symptom being a little blood then you may not be flaring at all, perhaps you just have some hemorrhoids. I would check that out before escalating to something more drastic.

about 15 percent of IBDers are helped by antibiotics, and apparently you and I are in that group. Flagyl knocked out my flares more than once. I really do not not not want to depend on abx for remission because they do have side effects and I am afraid that someday they will stop working, and that would send me up the creek. So I try to stay in remission by keeping a food diary and taking supplements, antibiotics are only a last resort.

If you are taking antibiotics then you should also take probiotics along with them. ABX kill both good and bad bacteria and you will need to replace the good bacteria. For example Flagyl has been known to later cause C Diff infections. A good probiotic to take while on antibiotics is S. Boulardii which is a probiotic YEAST and therefore immune from being killed by the Flagyl. And it specifically targets C. Diff. I take an assortment of probiotics and it seems to help.
Posted 3/23/2017 6:24 PM (GMT 0)
IamCurious, thanks for sharing your experience it is really interesting.

How long do you take Flagyl for when you flare? What is your "decision point", eg. when you have >10BMs per day with blood and mucus you decide to take ABX? How often have you taken ABX in one year?

thanks!
Posted 3/23/2017 11:44 PM (GMT 0)
I believe I took 500 mg of Flagyl 3 times a day for about 10 days. By being very careful after achieving remission and watching my diet and taking daily supplements (see my signature) I could maintain a multi-year remission. I would only take antibiotics as a last resort after diet and supplements no longer were effective.

Otherwise whenever symptoms would start to creep into my life, but before an actual flare, I would take some powdered psyllium SEED mixed with two packets of VSL#3DS. It tasted like dirt and I couldn't stand drinking it but after a day or two my intestines would feel all patched up and be back into remission. But once a full-blown flare started then only antibiotics would get me out of it. I needed to use antibiotics 3 times since 2010.
Posted 3/24/2017 2:52 AM (GMT 0)
Ciproflaxin-brake in half
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