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Probiotic therapy for pouchitis and its endoscopic findings
Author(s) -
MIMURA TOSHIKI,
KAMINISHI MICHIO,
KAMM MICHAEL A.
Publication year - 2002
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2002.00168.x
Subject(s) - pouchitis , medicine , ulcerative colitis , proctocolectomy , metronidazole , probiotic , gastroenterology , pouch , ileostomy , antibiotics , anastomosis , inflammatory bowel disease , disease , surgery , genetics , bacteria , microbiology and biotechnology , biology
Restorative proctocolectomy with ileal pouch anal anastomosis has become the most frequently performed operation for ulcerative colitis. Patients having this operation, however, experience more short‐ and long‐term complications than those with a permanent ileostomy. Pouchitis, acute non‐specific inflammation within an ileal pouch, is one of the most common long‐term complications after this procedure, and is specific to it. Although most pouchitis is amenable to simple antibiotic therapy including metronidazole and ciprofloxacin, 5–15% of patients suffer from refractory pouchitis, in which the acute inflammation either relapses frequently after the cessation of the antibiotics or does not respond to them at all. Probiotic therapy is intended to re‐establish natural bacterial conditions with live organisms belonging to natural bacterial flora. Recently, there have been an increasing number of reports that probiotic therapy is effective for inflammatory bowel disease including pouchitis, and might be the best approach to treat them. In this paper, the rationale and evidence for benefit of probiotic therapy in treating pouchitis have been reviewed, and representative endoscopic pictures of pouchitis have been included.