Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

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

Question 10: My Patient With An Ileo Pouch-Anal Anastomosis Has Developed Diarrhea And Urgency. What Is The Differential Diagnosis, And How Should I Evaluate Him? What Is The Significance Of Pre-Pouch Ileitis? (continued)

Simon McLaughlin, MBBS, MD(Res)

Ileo pouch-anal anastomosis (IPAA) is the surgical procedure of choice in all patients with ulcerative colitis (UC) who require surgery. While the majority of patients have an excellent functional outcome, pouch dysfunction is common and may occur soon after surgery or develop many years later with good intervening pouch function. When approaching the IPAA patient presenting with diarrhea and urgency, it is important to obtain a complete medical history, and access to the patient’s previous medical records is helpful. Key information to obtain from the medical records is the…