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Management of Pouchitis

  • Paolo Gionchetti
  • Claudia Morselli
  • Fernando Rizzello
  • Rosy Tambasco
  • Gilberto Poggioli
  • Silvio Laureti
  • Federica Ugolini
  • Filippo Pierangeli
  • Massimo Campieri

Keywords

Ileal Pouch Restorative Proctocolectomy Inflammatory Bowel Disease Questionnaire Ileal Reservoir Chronic Pouchitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Parks AG, Nicholls RJ (1978) Proctocolectomy without ileostomy for ulcerative colitis. BMJ 2:85–88PubMedCrossRefGoogle Scholar
  2. 2.
    Pemberton JH, Kelly KA, Beart RW Jr et al (1987) Ileal pouch-anal anastomosis for chronic ulcerative colitis: long-term results. Ann Surg 206:504–513PubMedCrossRefGoogle Scholar
  3. 3.
    Nicholls RJ, Moskowitz RL, Shepherd NA (1985) Restorative proctocolectomy with ileal reservoir. Br J Surg 72:S76–S79PubMedCrossRefGoogle Scholar
  4. 4.
    Muir AJ, Edwards LJ, Sanders LL et al (2001) A prospective evaluation of health related quality of life after ileal pouch-anal anastomosis for ulcerative colitis. Am J Gastroenterol 96:1480–1485PubMedCrossRefGoogle Scholar
  5. 5.
    Shepherd NA, Hulten L, Tytgat GNJ et al (1989) Workshop: pouchitis. Int J Colorectal Dis 4:205–229PubMedCrossRefGoogle Scholar
  6. 6.
    Stahlberg D, Gullberg K, Liljeqvist L et al (1996) Pouchitis following pelvic pouch operation for ulcerative colitis: incidence, cumulative risk and risk factors. Dis Colon Rectum 39:1012–1018PubMedCrossRefGoogle Scholar
  7. 7.
    Simchuk EJ, Thirlby RC (2000) Risk factors and true incidence of pouchitis in patients after ileal pouchanal anastomosis. World J Surg 24:851–856PubMedCrossRefGoogle Scholar
  8. 8.
    Lohmuller JL, Pemberton JH, Dozois RR et al (1990) Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis. Ann Surg 211:622PubMedGoogle Scholar
  9. 9.
    Zins BJ, Sandborn WJ, Penna CR et al (1995) Pouchitis disease course after orthotopic liver transplantation in patients with primary sclerosing cholangitis and an ileal pouch-anal anastomosis. Am J Gastroenterol 90:2177PubMedGoogle Scholar
  10. 10.
    Duerr RH, Targan SR, Landers CJ et al (1991) Antineutrophil cytoplasmic antibodies in ulcerative colitis: comparison with other colitides/diarrhea illness. Gastroenterology 110:1590Google Scholar
  11. 11.
    Reumaux D, Colombel JF, Duclos B et al (1993) Anti-neutrophil cytoplasmic auto-antibodies in sera from patients with ulcerative colitis after proctocolectomy with ileo-anal anastomosis. Adv Exp Med Biol 336:523PubMedGoogle Scholar
  12. 12.
    Vecchi M, Gionchetti P, Bianchi MB et al (1994) PANCA and development of pouchitis in ulcerative colitis patients after proctocolectomy and ileal pouchanal anastomosis. Lancet 344:886PubMedCrossRefGoogle Scholar
  13. 13.
    Sandborn WJ, Landers CJ, Tremaine WJ et al (1995) Antineutrophil cytoplasmic antibody correlates with chronic pouchitis after ileal pouch-anal anastomosis. Am J Gastroenterol 90:740PubMedGoogle Scholar
  14. 14.
    Patel RT, Stokes R, Birch D et al (1996) Influence of total colectomy on serum antineutrphil cytoplasmic antibody in pouchitis after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Scand J Gastroenterol 31:594Google Scholar
  15. 15.
    Yang P, Oresland T, Jarnerot G et al (1996) Perinuclear antineutrophil cytoplasmic antibody in pouchitis after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Scand J Gastroenterol 31:594PubMedGoogle Scholar
  16. 16.
    Samarasekera DN, Stebbing JF, Kettlewell MG et al (1996) Outcome of restorative proctocolectomy with ileal reservoir for ulcerative colitis: comparison of distal colitis with more proximal disease. Gut 38:574–577PubMedGoogle Scholar
  17. 17.
    Schmidt CM, Lazenby AJ, Hendrickson RJ et al (1998) Pre-operatve terminal, ileal and colonic resection histopathology predicts risk of pouchitis in patients after ileo anal pull-through procedure. Ann Surg 227:654–662; Discussion 663–665PubMedCrossRefGoogle Scholar
  18. 18.
    Merrett MN, Mortensen N, Kettlewell M et al (1996) Smoking may prevent pouchitis in patients with restorative proctocolectomy for ulcerative colitis. Gut 38:362PubMedGoogle Scholar
  19. 19.
    Oresland T, Fasth S, Nordgren S et al (1992) A prospective randomised comparison of two different pelvic pouch design. Scand J Gastroenterol 25:986–996Google Scholar
  20. 20.
    Sagar PM, Holdsworth PJ, Godwin PJ et al (1992) Comparison of triplicated (S) and quadruplicated (W) pelvic ileal reservoirs: studies on manovolumetry, fecal bacteriology, fecal volatile fatty acids, mucosal morphology, and functional results. Gastroenterology 102:520–528PubMedGoogle Scholar
  21. 21.
    Sandborn WJ (1994) Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis and treatment. Gastroenterology 107:1856–1860PubMedGoogle Scholar
  22. 22.
    Madden MV, Farthing MJ, Nicholls RJ (1990) Inflammation in the ileal reservoir: pouchitis. Gut 31:247–249PubMedGoogle Scholar
  23. 23.
    Di Febo G, Miglioli M, Lauri A et al (1990) Endoscopic assessment of acute inflammation of the reservoir after restorative proctocolectomy with ileoanal reservoir. Gastrointest Endosc 36:6–9PubMedCrossRefGoogle Scholar
  24. 24.
    Moskowitz RL, Shepherd NA, Nicholls RJ (1986) An assessment of inflammation in the reservoir after restorative proctocolectomy with ileoanal ileal reservoir. Int J Colorectal Dis 1:167–174PubMedCrossRefGoogle Scholar
  25. 25.
    Shepherd NA, Jass JR, Duval I et al (1987) Restorative proctoclolectomy with ileal reservoir: pathological and histochemical study of mucosal biopsy. J Clin Pathol 40:601–607PubMedGoogle Scholar
  26. 26.
    Sandborn WJ, Tremaine WJ, Batts KP et al (1994) Pouchitis after ileal pouch-anal anastomosis: a pouchitis disease activity index. Mayo Clinic Proc 69:409–415Google Scholar
  27. 27.
    Shen B, Achkar JP, Lashner BA et al (2001) Edoscopic and histologic evaluation together with symptoms assessment are required to diagnose pouchitis. Gastroenterology 121:261–267PubMedCrossRefGoogle Scholar
  28. 28.
    Moonka D, Furth EE, MacDermott RP, Lichtentein GR (1998) Pouchitis associated with primary cytomegalovirus infection. Am J Gastroenterol 93:264–266PubMedCrossRefGoogle Scholar
  29. 29.
    Munoz-Juarez M, Pemberton JH, Sandborn WJ et al (1999) Misdiagnosis of specific cytomegalovirus infection of the ileoanal pouch as refractory idiopathic chronic pouchitis: report of two cases. Dis Colon Rectum 42:117–120PubMedCrossRefGoogle Scholar
  30. 30.
    Thompson-Fawcett MW Mortensen NJ, Warren BF (1999) “Cuffitis” and inflammatory changes in the columnar cuff, anal transitional zone and ileal reservoir after stapled pouch-anal anastomosis. Dis Colon Rectum 42:348–355PubMedCrossRefGoogle Scholar
  31. 31.
    Shen B, Achkar JP, Lashner BA et al (2002) Irritable pouch syndrome: a new category of diagnosis for symptomatic patients with ileal pouch-anal anastomosis. Am J Gastroenterol 97:972–977PubMedCrossRefGoogle Scholar
  32. 32.
    Sandborn WJ, Mc Leod, Jewell DP (1999) Medical therapy for induction and maintenance of remission in pouchitis: a systematic review. Inflamm Bowel Dis 5:33–39PubMedCrossRefGoogle Scholar
  33. 33.
    Hurst RD, Molinari M, Chung P et al (1996) Prospective study of the incidence, timing and treatment of pouchitis in 104 consecutive patients after restorative proctocolectomy. Arch Surg 131:497–502PubMedGoogle Scholar
  34. 34.
    Keighley MRB (1996) Review article: the management of pouchitis. Aliment Pharmacol Ther 10:449–457PubMedCrossRefGoogle Scholar
  35. 35.
    Madden M, McIntyre A, Nicholls RJ (1994) Double-blind cross-over trial of metronidazole versus placebo in chronic unremitting pouchitis. Dig Dis Sci 39:1193–1196PubMedCrossRefGoogle Scholar
  36. 36.
    Shen B, Achkar JP, Lashner BA et al (2001) A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. Inflamm Bowel Dis 7:301–305PubMedCrossRefGoogle Scholar
  37. 37.
    Sambuelli A, Boerr L, Negreira S et al (2002) Budesonide enema in pouchitis: a double-blind, doubledummy, controlled trial. Aliment Pharmacol Ther 16:27–34PubMedCrossRefGoogle Scholar
  38. 38.
    Miglioli M, Barbara L, Di Febo G et al (1989) Topical administration of 5-aminosalicylic acid: a therapeutic proposal for the treatment of pouchitis. N Engl J Med 320:257PubMedGoogle Scholar
  39. 39.
    Winter TA, Dalton HR, Merrett MN et al (1993) Cyclosporine A retention enemas in refractory distal ulcerative colitis and pouchitis. Scand J Gastroenterol 28:701–704PubMedGoogle Scholar
  40. 40.
    Clausen MR, Tvede M, Mortensen PB (1992) Short chain fatty acids in pouch contents with and without pouchitis after ileal pouch-anal anastomosis. Gastroenterology 103:1144–1449PubMedGoogle Scholar
  41. 41.
    Sandborn WJ, Tremaine WJ, Batts KP et al (1995) Faecal bile acids, short-chain fatty acids and bacteria after ileal pouch-anal anastomosis do not differ in patients with pouchitis. Dig Dis Sci 40:1474–1483PubMedCrossRefGoogle Scholar
  42. 42.
    De Silva HJ, Ireland A, Kettlewell M et al (1989) Shortchain fatty acids irrigation in severe pouchitis. N Engl J Med 321:416–417Google Scholar
  43. 43.
    Tremaine WJ, Sandborn WJ, Phillips SF et al (1999) Short-chain fatty acid (SCFA) enema therapy for treatment-resistant pouchitis following ileal pouch-anal anastomosis (IPAA) for ulcerative colitis. Gastroenterology 106:A784Google Scholar
  44. 44.
    Wischmeyer P, Pemberton JH, Phillips SF (1993) Chronic pouchitis after ileal pouch-anal anastomosis: responses to butyrate and glutamine suppositories in a pilot study. Mayo Clin Proc 68:978–981PubMedGoogle Scholar
  45. 45.
    Gionchetti P, Rizzello F, Venturi A et al (1997) Longterm efficacy of bismuth carbomer enemas in patients with treatment-resistant chronic pouchitis. Aliment Pharmacol Ther 11:673–678PubMedCrossRefGoogle Scholar
  46. 46.
    Tremaine WJ, Sandborn WJ, Wolff BG et al (1997) Bismuth carbomer foam enemas for active chronic pouchitis: a randomised, double-blind, placebo-controlled trial. Aliment Pharmacol Ther 11:1041–1046PubMedCrossRefGoogle Scholar
  47. 47.
    Tremaine WJ, Sandborn WJ, Kenan ML (1998) Bismuth subsalicylate tablets for chronic antibioticresistant pouchitis. Gastroenterology 114:A1101CrossRefGoogle Scholar
  48. 48.
    Joelsson M, Andersson M, Bark T et al (2001) Allopurinol as prophylaxis against pouchitis following ileal pouch-anal anastomosis for ulcerative colitis: a randomised placebo-controlled double-blind study. Scand J Gastroenterol 36:1179–1184PubMedCrossRefGoogle Scholar
  49. 49.
    Gionchetti P, Rizzello F, Venturi A et al (1999) Antibiotic combination therapy in patients with chronic, treatment-resistant pouchitis. Aliment Pharmacol Ther 13:713–718PubMedCrossRefGoogle Scholar
  50. 50.
    Mimura T, Rizzello F, Helwig U et al (2002) Four week open-label trial of metronidazole and ciprofloxacin for the treatment of recurrent or refractory pouchitis. Aliment Pharmacol Ther 16:909–917PubMedCrossRefGoogle Scholar
  51. 51.
    Gionchetti P, Rizzello F, Morselli C et al (2004) Eight-week open trial of oral budesonide for the treatment of refractory pouchitis. Gastroenterology 126:A123CrossRefGoogle Scholar
  52. 52.
    Gionchetti P, Morselli C, Rizzello F et al (2005) Infliximab in the treatment of Refractory pouchitis. Gastroenterology 128:A578Google Scholar
  53. 53.
    Schaafsma G (1996) State of the art concerning probiotic strains in milk products. IDF Nutr Newsl 5:23–24Google Scholar
  54. 54.
    Campieri M, Gionchetti P (1999) Probiotics in inflammatory bowel disease:new insight to pathogenesis or a possible therapeutic alternative? Gastroenterology 116:1246–1249PubMedCrossRefGoogle Scholar
  55. 55.
    Gionchetti P, Rizzello F, Venturi A et al (2000) Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119:305–309PubMedCrossRefGoogle Scholar
  56. 56.
    Mimura T, Rizzello F, Schreiber S et al (2002) Once daily high dose probiotic therapy maintains remission and improves quality of life in patients with recurrent or refractory pouchitis: a randomised, placebo-controlled, double-blind trial. Gastroenterology 122:A81Google Scholar
  57. 57.
    Gionchetti P, Rizzello F, Helvig U et al (2003) Prophylaxis of pouchitis onset with probiotic therapy: a double-blind placebo controlled trial. Gastroenterology 124:1202–1209PubMedCrossRefGoogle Scholar
  58. 58.
    Amadini C, Gionchetti P, Rizzello F et al (2002) High dose probiotics are effective in the treatment of mild pouchitis: a pilot study. Dig Liver Dis 34:A96CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • Paolo Gionchetti
    • 1
  • Claudia Morselli
    • 1
  • Fernando Rizzello
    • 1
  • Rosy Tambasco
    • 1
  • Gilberto Poggioli
    • 2
  • Silvio Laureti
    • 2
  • Federica Ugolini
    • 3
  • Filippo Pierangeli
    • 2
  • Massimo Campieri
    • 1
  1. 1.Department of Internal Medicine and GastroenterologyUniversity of BolognaBolognaItaly
  2. 2.Unit of General Surgery Policlinico S. Orsola-MalpighiUniversity of BolognaBolognaItaly
  3. 3.Unit of General Surgery S. Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly

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