Ulcerative Colitis: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 36: Management of Acute and Chronic Pouchitis (continued)

James M. Becker, MD, FACS; Arthur F. Stucchi, PhD

MANAGEMENT OF ACUTE AND CHRONIC POUCHITIS Although the majority of patients with chronic ulcerative colitis (UC) can be managed medically, an estimated 30 to 40% will eventually require a total proctocolectomy either to control the refractory nature of their disease or to alleviate the escalating potential for malignancy.1 Until recently, these patients, many of whom are quite young, were left with a permanent Brooke ileostomy that was poorly accepted by both patients and physicians. In fact, patients often refused or delayed curative proctocolectomy because of their aversion to a Brooke…