Clinical guidelines for the management of pouchitis

When surgery is necessary in patients with ulcerative colitis, total proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the procedure of choice. Several inflammatory and noninflammatory complications can occur after IPAA. Pouchitis is the most common, occurring in ≈50% of patients. Whereas “acute” pouchitis can be treated rapidly and successfully in the majority of patients, “refractory” and “chronic pouchitis” remain therapeutic challenges to patients and physicians. This article reviews the literature and offers consensus guidelines on issues related to the epidemiology, diagnosis, pathogenesis, risk factors, and treatment of pouchitis. Inflamm Bowel Dis