Open AccessPouchitis: Treatment dilemmas at different stages of the disease
Author(s) -
Barreirode Acosta Manuel,
BastónRey Iria,
CalviñoSuárez Cristina,
Enrique DomínguezMuñoz J
Publication year - 2020
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640619900571
Subject(s) - pouchitis , medicine , ulcerative colitis , proctocolectomy , etiology , pouch , anastomosis , complication , inflammatory bowel disease , refractory (planetary science) , gastroenterology , surgery , ileostomy , crohn's disease , disease , physics , astrobiology
Pouchitis is a frequent complication in ulcerative colitis patients after proctocolectomy with ileal pouch–anal anastomosis. It is an unspecific inflammation of the pouch with unknown aetiology. First‐line treatment for acute and chronic pouchitis is antibiotics. Some cases of severe chronic refractory pouchitis may benefit from biological treatment. Anti‐tumour necrosis factor should be recommended as the first option, leaving the new biologicals for multirefractory patients. Permanent ileostomy may be an option in severe cases, after failure of medical treatment. Prophylaxis therapy with a probiotic mixture is recommended after the first episode of pouchitis, whereas it is not clear whether probiotics are useful for all patients after surgery. Here, we present a case report and review the treatment options in different forms of pouchitis.