The role of endoscopy in pouch monitoring and pouchitis

Abstract

Endoscopy has a dual role in pouch monitoring. First of all, it is important in monitoring the healing process before closure of the protective ileostomy. Initially, the area of the anastomosis is severely inflamed and friable and some ulceration and swelling is seen along the suture lines. Later on, after two to three months, both the anastomotic line and the suture lines have completely healed (Fig. 5). It has been our policy to close the ileostomy only after full endoscopic healing of the pouch. The normal small bowel mucosa has a clearly visible vascular pattern upon distension.