Skip to main content

Endoscopy in Crohn’s Disease of the Pouch

  • Chapter
  • First Online:
Endoscopy in Inflammatory Bowel Disease
  • 1478 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Melton GB, Fazio VW, Kiran RP, He J, Lavery IC, Shen B, Achkar JP, Church JM, Remzi FH. Long-term outcomes with ileal pouch-anal anastomosis and Crohn’s disease: pouch retention and implications of delayed diagnosis. Ann Surg. 2008;248:608–16.

    PubMed  Google Scholar 

  2. Shen B, Fazio VW, Remzi FH, et al. Risk factors for clinical phenotypes of Crohn’s disease of the pouch. Am J Gastroenterol. 2006;101:2760–8.

    Article  PubMed  Google Scholar 

  3. Wu XR, Mukewar S, Kiran RP, Hammel JP, Remzi FH, Shen B. The presence of primary sclerosing cholangitis is protective for ileal pouch from Crohn's disease. Inflamm Bowel Dis. 2013;19:1483–9.

    Article  PubMed  Google Scholar 

  4. Shen B, Bennett AE, Navaneethan U, Lian L, Kiran R, Fazio VW, Remzi FH. Primary sclerosing cholangitis is associated with endoscopic and histologic inflammation of distal afferent limb in patients with ileal pouch-anal anastomosis. Inflamm Bowel Dis. 2011;17:1890–900.

    Article  PubMed  Google Scholar 

  5. Shen B, Fazio VW, Bennett AE, Remzi FH, Bennett AE, Lopez R, Brzezinski A, Bambrick ML, Sherman KK, Lashner BA. Effect of withdrawal of non-steroidal anti-inflammatory drug use in patients with the ileal pouch. Dig Dis Sci. 2007;52:3321–8.

    Article  CAS  PubMed  Google Scholar 

  6. Liu ZX, Deroche T, Remzi FH, Hammel JP, Fazio VW, Ni RZ, Goldblum JR, Shen B. Transmural inflammation is not pathognomnic for Crohn’s disease of the pouch. Surg Endosc. 2011;25:3509–17.

    Article  PubMed  Google Scholar 

  7. Shen B, Plesec TP, Remer E, Remzi FH, Kiran RP, Lopez R, Fazio VW, Goldblum JR. Asymmetric inflammation of ileal pouch: a sign for ischemic pouchitis? Inflamm Bowel Dis. 2010;16:836–46.

    Article  PubMed  Google Scholar 

  8. Shen B, Fazio VW, Remzi FH, et al. Clinical features and quality of life in patients with different phenotypes of Crohn’s disease of the pouth. Dis Colon Rectum. 2007;50:1450–9.

    Article  PubMed  Google Scholar 

  9. Shen B, Lian L, Kiran RP, Queener E, Lavery IC, Fazio VW, Remzi FH. Efficacy and safety of endoscopic treatment of ileal pouch strictures. Inflamm Bowel Dis. 2011;17:2527–35.

    Article  PubMed  Google Scholar 

  10. Wu XR, Mukewar S, Kiran RP, Remzi FH, Shen B. Surgical stricturoplasty in the treatment of ileal pouch strictures. J Gastrointest Surg. 2013;17:1452–61.

    Article  PubMed  Google Scholar 

  11. Shen B. Crohn’s disease of the ileal pouch: reality, diagnosis, and management. Inflamm Bowel Dis. 2009;15(2):284–94.

    Article  PubMed  Google Scholar 

Download references

Disclosure

The author has received honoraria from Aptalis, Abbvie, Jassen, and Prometheus Lab.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bo Shen MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Shen, B. (2015). Endoscopy in Crohn’s Disease of the Pouch. In: Kozarek, R., Chiorean, M., Wallace, M. (eds) Endoscopy in Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-11077-6_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-11077-6_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11076-9

  • Online ISBN: 978-3-319-11077-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics