Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on pouchitis in ulcerative colitis. Part 1: Epidemiology, diagnosis and prognosis

Gastroenterol Hepatol. 2019 Nov;42(9):568-578. doi: 10.1016/j.gastrohep.2019.08.001. Epub 2019 Oct 9.
[Article in English, Spanish]

Abstract

Pouchitis is a common complication in ulcerative colitis patients after total proctocolectomy. This is an unspecific inflammation of the ileo-anal pouch, the aetiology of which is not fully known. This inflammation induces the onset of symptoms such as urgency, diarrhoea, rectal bleeding and abdominal pain. Many patients suffering from pouchitis have a lower quality of life. In addition to symptoms, an endoscopy with biopsies is mandatory in order to establish a definite diagnosis. The recommended index to assess its activity is the Pouchitis Disease Activity Index (PDAI), but its modified version (PDAIm) can be used in clinical practice. In accordance with the duration of symptoms, pouchitis can be classified as acute (<4 weeks) or chronic (>4 weeks), and, regarding its course, pouchitis can be infrequent (<4 episodes per year), recurrent (>4 episodes per year) or continuous.

Keywords: Colitis ulcerosa; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Pouchitis; Reservoritis; Ulcerative colitis.

MeSH terms

  • Acute Disease
  • Chronic Disease
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / surgery
  • Colonic Pouches
  • Consensus*
  • Diagnosis, Differential
  • Humans
  • Incidence
  • Intestinal Mucosa
  • Ischemia / complications
  • Postoperative Complications
  • Pouchitis / classification
  • Pouchitis / diagnosis*
  • Pouchitis / epidemiology*
  • Pouchitis / etiology
  • Proctocolectomy, Restorative
  • Prognosis
  • Quality of Life
  • Risk Factors
  • Severity of Illness Index