| Theme | Therapeutic strategy for ulcerative colitis ; from standard to up-to-date | |
|---|---|---|
| Title | Pouchitis：Diagnosis and treatment | |
| Publish Date | 2011/05 | |
| Author | Ritsuko Fujisawa | Kyushu Dental College / Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University |
| Author | Takayuki Matsumoto | Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu Universityl |
| Author | Yuji Maehata | Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu Universityl |
| [ Summary ] | Total proctocolectomy is one choice for the treatment of ulcerative colitis. Pouchitis is a common complication in patients treated by total proctocolectomy with ileal pouch-anal anastomosis (IPAA). Approximately 10-50 % of the patients with IPAA experience acute pouchitis, 10-20 % which develop chronic pouchitis. Increased stool frequency, urgency, incontinence, nocturnal seepage, abdominal cramping, and pelvic discomfort are the most common presenting symptoms. Acute pouchitis can be successfully treated with antibiotic therapy with metronidazole or ciprofloxacine. However, as well as ulcerative colitis, refractory or persistent pouchitis also requires maintenance therapy with mesalamine, corticosteroids, immunomodulators or infliximab. Because pouchitis may possibly result in pouch failure, we should carefully treat patients with chronic or refractory pouchitis. | |