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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Shen B. Crohn’s disease of the ileal pouch: reality, diagnosis, and management. Inflamm Bowel Dis. 2009;15(2):284–94.
Disclosure
The author has received honoraria from Aptalis, Abbvie, Jassen, and Prometheus Lab.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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)