Pouchitis: what every gastroenterologist needs to know

Clin Gastroenterol Hepatol. 2013 Dec;11(12):1538-49. doi: 10.1016/j.cgh.2013.03.033. Epub 2013 Apr 16.


Pouchitis is the most common complication among patients with ulcerative colitis who have undergone restorative proctocolectomy with ileal pouch-anal anastomosis. Pouchitis is actually a spectrum of diseases that vary in etiology, pathogenesis, phenotype, and clinical course. Although initial acute episodes typically respond to antibiotic therapy, patients can become dependent on antibiotics or develop refractory disease. Many factors contribute to the course of refractory pouchitis, such as the use of nonsteroidal anti-inflammatory drugs, infection with Clostridium difficile, pouch ischemia, or concurrent immune-mediated disorders. Identification of these secondary factors can help direct therapy.

Keywords: CARD15; CARP; CD; CDI; CMV; Clostridium difficile infection; Crohn's disease; FAP; IBD; IL; IPAA; IPS; Ileal Pouch; NOD2; NSAID; PSC; Pouchitis; Restorative Proctocolectomy; TNF; UC; Ulcerative Colitis; caspase recruitment domain family, member 15; chronic antibiotic-refractory pouchitis; cytomegalovirus; familial adenomatous polyposis; ileal pouch-anal anastomosis; inflammatory bowel disease; interleukin; irritable pouch syndrome; nonsteroidal anti-inflammatory drug; nucleotide-binding oligomerization domain containing 2; primary sclerosing cholangitis; tumor necrosis factor; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Colonic Pouches / pathology*
  • Humans
  • Pouchitis / diagnosis*
  • Pouchitis / therapy*