Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 25: How Do You Treat Pouchitis? What Do You Do For Recurrent Or Refractory Pouchitis? (continued)

Bo Shen, MD

Pouchitis is the most common complication after restorative proctocolectomy for patients with ulcerative colitis (UC). Pouchitis has traditionally been considered a disease condition related to abnormal alterations in the composition of commensal microbiota. This notion is based on the clinical observation that the majority of patients with initial episodes of pouchitis respond favorably to therapy with broad-spectrum antibiotics and because bacterial, fungal, or viral pathogens are identified only in a small subset of patients. Patients with pouchitis often present with increased stool…