Background: Refractory pouchitis is a common cause of pouch failure, which may require surgical excision of the pouch or permanent diversion. We aimed to show the effect of vedolizumab on treatment of the patient with refractory pouchitis.
Case summary: A 32-year-old male with pancolonic ulcerative colitis since the age of 25 with primary failure of infliximab and mesalamine and intolerance of azathioprine, underwent a total proctocolectomy with ileal pouch-anal anastomosis in 2012. He developed chronic diarrhea in 2014, which was watery, 30 per day and accompanied with blood and mucus affecting his quality of life.
Conclusion: Vedolizumab is safe and effective in the management of anti-tumor necrosis factor alpha refractory pouchitis.
Keywords: Anti-tumor necrosis factor alpha; Refractory pouchitis; Ulcerative colitis; Vedolizumab.