Pouchitis

Pouchitis is an inflammatory reaction occurring after ideal pouch anal anastomosis, which is a treatment of choice for patients who have medically refractory ulcerative colitis with dysplasia or cancer, and for patients with familial adenomatous polyposis. This operation allows continence, with typically 3 to 4 bowel movements per day. Pouchitis is an inflammatory reaction occurs in about 50% of patients. It is thought to be related to bacterial overgrowth and is treated with antibiotics, and probiotics may be protective. Most cases of pouchitis are readily controlled, but about 5 to 10% may prove refractory to all medical therapy. Alternative surgical procedures include a continent ileostomy or more often traditional ileostomy. The physical and emotional burdens imposed on the patient should be recognized, and care should be taken to see that the patient receives all necessary instructions and psychological support.