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Pediatric Inflammatory Bowel Disease pp 543–555Cite as

Pouchitis After Ileal Pouch-Anal Anastomosis

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Abstract

Pouchitis is defined as inflammation of the ileal reservoir in patients status post proctocolectomy with ileal pouch-anal anastomosis (IPAA). Proctocolectomy with IPAA has emerged as the surgical procedure of choice for patients diagnosed with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) syndrome. Pouchitis is the most common long-term complication of IPAA and is a significant cause of morbidity related to the procedure. Important risk factors in the development of pouchitis include immune dysregulation, bacterial overgrowth and dysbiosis, fecal stasis, malnutrition, ischemia, and undiagnosed Crohn’s disease (CD). Pouchitis is classified by severity, duration, frequency, and response to therapy. Treatment approaches include both primary prophylaxis and following the development of symptoms with probiotics, antibiotics, topical therapy, immunosuppression, and, if needed, surgery.

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Authors and Affiliations

  1. Cleveland Clinic Foundation, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland, OH, USA

    Jacob Kurowski MD, Marsha Kay MD & Robert Wyllie MD

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  1. Jacob Kurowski MD
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  2. Marsha Kay MD
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  3. Robert Wyllie MD
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Correspondence to Robert Wyllie MD .

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Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Andrew B. Grossman

  3. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Robert N. Baldassano

  4. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Judith R. Kelsen

  5. Division of Pediatric Gastroenterology & Nutrition, University of South Carolina School of Medicine - Greenville, Greenville, South Carolina, USA

    Jonathan E. Markowitz

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Kurowski, J., Kay, M., Wyllie, R. (2017). Pouchitis After Ileal Pouch-Anal Anastomosis. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_44

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