Gut Instincts: A Clinician's Handbook of Digestive and Liver Diseases

Eric Esrailian, MD, MPH

Chapter 18: Pouchitis (continued)

Udayakumar Navaneethan, MD; Bo Shen, MD, FACG

Approximately 30% of patients with ulcerative colitis (UC) eventually require colectomy at some point, despite advances in medical therapy. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice for the majority of patients with medically refractory UC, UC with dysplasia, or familial adenomatous polyposis. Pouchitis is a nonspecific inflammation of the ileal pouch reservoir and is the most frequent long-term complication of IPAA in patients with UC, with a cumulative prevalence of up to 50%. There is not a uniform system for the…