Pouchitis after ileal pouch-anal anastomosis for ulcerative colitis occurs with increased frequency in patients with associated primary sclerosing cholangitis.
Christophe Penna,Roger R. Dozois,William J. Tremaine,William J. Sandborn,Nicholas F. LaRusso,Cathy D. Schleck,Duane M. Ilstrup +6 more
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TLDR
The strong correlation between PSC and pouchitis suggest a common link in their pathogenesis and may be associated with pouchitis after ileal pouch-anal anastomosis.Abstract:
Primary sclerosing cholangitis (PSC), present in 5% of patients with ulcerative colitis, may be associated with pouchitis after ileal pouch-anal anastomosis. The cumulative frequency of pouchitis in patients with and without PSC who underwent ileal pouch-anal anastomosis for ulcerative colitis was determined. A total of 1097 patients who had an ileal pouch-anal anastomosis for ulcerative colitis, 54 with associated PSC, were studied. Pouchitis was defined by clinical criteria in all patients and by clinical, endoscopic, and histological criteria in 83% of PSC patients and 85% of their matched controls. PSC was defined by clinical, radiological, and pathological findings. One or more episodes of pouchitis occurred in 32% of patients without PSC and 63% of patients with PSC. The cumulative risk of pouchitis at one, two, five, and 10 years after ileal pouch-anal anastomosis was 15.5%, 22.5%, 36%, and 45.5% for the patients without PSC and 22%, 43%, 61%, and 79% for the patients with PSC. In the PSC group, the risk of pouchitis was not related to the severity of liver disease. In conclusion, the strong correlation between PSC and pouchitis suggest a common link in their pathogenesis.read more
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References
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Journal ArticleDOI
Pouchitis After Ileal Pouch-Anal Anastomosis: A Pouchitis Disease Activity Index
William J. Sandborn,William J. Tremaine,Kenneth P. Batts,John H. Pemberton,Sidney F. Phillips +4 more
TL;DR: The PDAI provides simple, objective, and quantitative criteria for pouch inflammation after IPAA and is more sensitive than prior scoring systems.
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Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results.
John H. Pemberton,Keith A. Kelly,Robert W. Beart,Roger R. Dozois,Bruce G. Wolff,Duane M. Ilstrup +5 more
TL;DR: The results support the ileal pouch-anal anastomosis as a safe, satisfactory alternative to permanent ileostomy in patients with ulcerative colitis over the long-term.
Journal ArticleDOI
Pouchitis following heal pouch-anal anastomosis: Definition, pathogenesis, and treatment
Journal Article
Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis.
TL;DR: It is concluded that pouchitis occurred frequently after IPAA and that patients with EIMs were at higher risk of developing pouchitis than were patients who never had EIM s and that some patients experienced a temporal relationship between flares of E IMs and pouchitis.
Journal ArticleDOI
An assessment of inflammation in the reservoir after restorative proctocolectomy with ileoanal ileal reservoir.
TL;DR: Investigation has aimed to determine the prevalence of inflammation, to define pouchitis and to examine some factors which might be related to inflammation.