Pouchitis

Pouchitis
Synonyms
Pronounce	N/A
Specialty	Gastroenterology
Symptoms	Abdominal pain, diarrhea, rectal bleeding, fever, fatigue
Complications	Dehydration, anemia, malnutrition
Onset
Duration
Types
Causes	Unknown, possibly related to bacterial overgrowth or immune response
Risks	History of ulcerative colitis, ileal pouch-anal anastomosis (IPAA) surgery
Diagnosis	Endoscopy, biopsy, stool tests
Differential diagnosis	Crohn's disease, infectious colitis, irritable bowel syndrome
Prevention
Treatment	Antibiotics, probiotics, dietary changes
Medication	Metronidazole, ciprofloxacin
Prognosis	Generally good with treatment, but may recur
Frequency	Affects up to 50% of patients with IPAA
Deaths	N/A

Pouchitis is an inflammation of the ileal pouch (an artificial rectum surgically created out of ileal gut tissue in patients who have undergone a colectomy), which is often associated with ulcerative colitis and familial adenomatous polyposis.

Symptoms

The symptoms of pouchitis can include increased frequency of bowel movements, abdominal cramping, increased stool liquidity, urgency, incontinence, and occasionally, fever or bleeding.

Causes

The exact cause of pouchitis is unknown, but it is thought to be related to an imbalance in the bacteria that normally live in the pouch. Other possible causes include ischemia (lack of blood flow), mechanical injury, or an autoimmune response.

Diagnosis

Diagnosis of pouchitis is typically made based on the patient's symptoms, a physical examination, and the results of a pouchoscopy (a type of endoscopy used to examine the pouch). During a pouchoscopy, a small camera is inserted into the pouch to look for signs of inflammation.

Treatment

Treatment for pouchitis typically involves antibiotics to help restore the balance of bacteria in the pouch. In some cases, probiotics may also be used. If these treatments are not effective, other medications such as immunosuppressants or biologics may be used.

See also

• Ulcerative colitis
• Familial adenomatous polyposis
• Colectomy
• Endoscopy
• Probiotics
• Immunosuppressants
• Biologics