Showing papers on "Pouchoscopy published in 2015"

Hyperbaric oxygen therapy for chronic antibiotic-refractory ischemic pouchitis.

Abstract: Hyperbaric oxygen therapy (HBOT) has been shown to be efficacious in treating various conditions, including perianal Crohn’s disease. Here we present a case of a 59-year-old male with a history of ulcerative colitis, who underwent a total proctocolectomy and two-stage J-pouch construction. He later developed chronic antibiotic-refractory pouchitis with endoscopic features of ischemia. At the completion of HOBT—a total of 20 sessions of 100% oxygen at 2.5‐3.0 atmospheres absolute for 60‐90 minutes per session—a repeat pouchoscopy showed marked improvement of endoscopic mucosal inflammation. HBOT is known to increase tissue oxygenation, reduce tissue hypoxia, alter inflammatory pathways and promote tissue healing. This case demonstrated the therapeutic role of HBOT as well as the possible disease mechanism in chronic antibiotic-refractory pouchitis.

Faecal matrix metalloprotease-9 is a more sensitive marker for diagnosing pouchitis than faecal calprotectin: results from a pilot study.

Abstract: Background: Potential non-invasive markers of pouchitis would have a great deal of significance within clinical practice. Aim: This study is aimed at assessing the diagnostic accuracy of fecal calprotectin and matrix metalloprotease-9 as potential markers in patients both with and without pouchitis. Patients and methods: Stool and blood samples were collected from 33 ileal pouch-anal anastomosis patients before a follow-up pouchoscopy. Biopsy samples were taken for histological purposes. The presence of cuffitis and stenosis was evaluated with an endoscopy. Calprotectin and matrix metalloprotease-9 were quantified with an enzyme-linked immunosorbent assay. Results: Pouchitis was detected in 30.3% of the patients. The levels of fecal calprotectin and matrix metalloprotease-9 increased significantly in patients with pouchitis. The sensitivity and specificity of matrix metalloprotease-9 was higher than that of fecal calprotectin. Only matrix metalloprotease-9 correlated significantly with the severity of pou...

Endoscopy in Crohn’s disease of the pouch

Abstract: Restorative proctocolectomy with ileal pouch-anal anastomosis is the standard surgical treatment modality for ulcerative colitis patients who require colectomy. While the surgical procedure improves health-related quality of life in patients with refractory colitis, it is associated with an array of mechanical, inflammatory, and functional disorders of the pouch. Crohn’s disease of the pouch is one of the most serious inflammatory complications. The majority of those patients develop the disease after surgery (de novo Crohn’s disease). Crohn’s disease of the pouch can be classified into inflammatory, stricturing, and fistulizing phenotypes. Pouchoscopy plays a key role in the diagnosis, differential diagnosis, and therapy for Crohn’s disease of the pouch.

What Is Life Like After Colectomy for UC? Ileal Pouch-Anal Anastomosis and Pouchitis

Abstract: Ileal pouch-anal anastomosis or “IPAA” is a surgical procedure to treat ulcerative colitis, where the entire colon is removed. The last portion of the small intestine is formed into a “pouch” and is attached internally to the anal sphincter muscle. This procedure is often done in two or three stages and usually involves a temporary ileostomy for 12–24 weeks, depending on the number of stages.