Hey Mark, thanks for this information - it's very, very helpful. Thank you
Umm, the antibiotics never gave me full relief on their own. But it's hard for me to say that they didn't assist me in some way. The relief that came while taking fluconazole was following some significant antibiotic therapy, so I think as you say, it could be multiple pathogens at play - one of which is candida/fungus-related. More recently, about 8 months ago, I was given itraconazole (Sporanox) to see if that had any impact as it is stronger than fluconazole, but all that did was cause some mild non-lasting hepatic damage. I have to admit, my diet while on itraconazole was nothing to write home about - I literally ate whatever, whenever, I wanted, with the exception of alcohol. I didn't drink during this period. I read elsewhere that a man was cured of fungal prostatitis using a combination of oral terbinafine and itraconazole, however I was told by two docs that they are known to interact with one another and cause cardiac issues - so who knows who to trust on that one?
Part of what I miss and what my partner misses too are aspects of our old lifestyle. I don't miss hangovers, but I do miss not being able to eat/drink more freely/socially. That's harder than the symptoms or even managing them, I think. The whole dealing with everyone else who doesn't understand or has a limited capacity for empathy, but an infinite capacity for unsolicited medical knowledge. I don't know about you - but I've received some absolutely outlandish suggestions from some otherwise very well-educated people. All are well-intentioned in my case, which is a positive, but their intent doesn't make it any less frustrating.
I like your approach about the kefir injections, dietary modifications and trying to crowd out gut bad bags. Especially since the prostate is a well of simple sugars, then modifying diet will play some role on prostate function, whether it's confirmed in the literature or not. I'm also hesitant to throw serious antibiotics at an "undiagnosed" problem. I know I have one, but without clear diagnosis, or rather, without a clear pathogenic agent identified, I don't want to treat on assumptions or educated guesses. Not yet, anyway...
On this front, I've read about rifaximin and VSL 3 probiotic being used for treatment of chronic bacterial prostatitis. After 12-months follow-up, those who were treated with the antibiotic and probiotic combination, had better bowel and bladder function compared to control. This was only published in 2014, so by the time a urologist sees it, who knows when that will be.
The urologists I've seen are beyond hopeless. The first one conducted two cystoscopies, a urodynamic study, other tests, and all was "normal" but I was advised that my prostate was slightly enlarged on one or two separate examinations, suggesting something was abnormal. The first one eventually said that he couldn't help me anymore, was puzzled, and referred me to a physiotherapist to work on my pelvic floor muscles which he said had tightened. The physiotherapist told me, upon hearing my story, that it was no surprise things had tightened up because I'd been experiencing severe diarrhoea for months, and after working through things with me said it wasn't even nearly as tight as the urologist had claimed. All things considered, this first urologist did have a kind bedside manner and he wasn't rude.
The second urologist was an outright d--khead. I only saw him for two appointments. He was rough during his examinations, and he acted like he had no f--ks left to give when speaking to me. I spent all of 5 minutes during two consultations in his clinic, and was charged greater than $500 for both, and prescribed two different strong antibiotics each time. I didn't take either of them, as this was post-FMT and despite my poor FMT results (detailed below), I didn't want to mess things up further by blindly taking antibiotics. Even if they are the right ones, something about the way they were given to me - "Try these, they might help. I don't know. Could be bad for you, I don't know. Do what you think is best" - makes me think not taking them might be the better option at this stage.
Centre for Digestive Diseases (CDD, Sydney) were unsatisfactory for me. They do excellent work for those suffering
Clostridium difficile infection and indeed this saves many lives, and they report excellent results treating a range of illnesses, including, but not limited to inflammatory and irritable bowel diseases and syndromes. However, when I first presented to them, they were not interested in either my comprehensive digestive stool analysis, or my BioScreen, which had 2-3 species of overgrown bacteria, presence of yeasts detected, and seemed to look at me and say, 'Yep, we can fix this/you'. They immediately prescribed vancomycin and rifaximin, and I took them. In many ways, the clinic's reputation precedes them and so I took them without hesitation. I didn't get better.
Within six months, I was having 10 FMTs there. I left thousands of dollars poorer and with a larger
Strep spp. overgrowth, and more gut imbalances than I first presented with, and most of the same symptoms. Add to that the depression which accompanies a failed treatment protocol and I wasn't in particularly high spirits. I'm young (under 30), and after months of keeping this to one side, I've recently ramped up my efforts for either: A) diagnosis and treatment or B) conservative management (i.e. kefir enemas, not FMT; "natural" antibiotics, not ciprofloxacin, as an example), and C) sensible symptom management (low-dose sleeping pills, when necessary).
At the moment, the "doing nothing" approach is and has impacted on my quality of life, so I've taken matters into my own hands a bit. And, I have to say, both your and Elph68's information, along with a few others on this forum, has been invaluable and I'm indebted to the collective research of others.