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Pouchitis: Management

Bo Shen, MD
Section Editor
Paul Rutgeerts, MD, PhD, FRCP
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Pouchitis is the most frequently observed long-term complication of an ileal pouch-anal anastomosis. This topic will review the management of pouchitis. The epidemiology, pathogenesis, clinical manifestations, and diagnosis of pouchitis are discussed in detail, separately. (See "Pouchitis: Epidemiology, clinical manifestations, and diagnosis".)


Pouchitis is an inflammatory condition of the ileal pouch reservoir of an ileal pouch-anal anastomosis (IPAA).

Classification — Pouchitis has been classified as follows [1]:

Based on the duration of symptoms into acute (<4 weeks) versus chronic (≥4 weeks).

Based on response to antibiotics into antibiotic-responsive versus antibiotic-dependent (requiring ongoing antibiotic therapy to keep disease in remission) versus antibiotic-refractory (not responding to standard course of antibiotic therapy).

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Literature review current through: Dec 2017. | This topic last updated: May 18, 2017.
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