Clinical approach to diseases of ileal pouch-anal anastomosis

Am J Gastroenterol. 2005 Dec;100(12):2796-807. doi: 10.1111/j.1572-0241.2005.00278.x.

Abstract

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for ulcerative colitis (UC) patients with medically refractory disease or dysplasia. IPAA significantly improves quality of life in UC patients who require surgery. However, certain inflammatory and noninflammatory diseases can develop after the surgery, including pouchitis, Crohn's disease of the pouch, cuffitis, and irritable pouch syndrome. The etiology and pathogenesis of these disease conditions of IPAA are largely unknown. Accurate diagnosis and classification are important for appropriate management. Endoscopic evaluation is the most important tool for the diagnosis and differential diagnosis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / surgery*
  • Colonic Pouches / adverse effects*
  • Colonoscopy / methods
  • Crohn Disease / drug therapy
  • Crohn Disease / pathology
  • Drug Therapy, Combination
  • Female
  • Humans
  • Irritable Bowel Syndrome / diagnosis
  • Irritable Bowel Syndrome / drug therapy
  • Male
  • Pouchitis / drug therapy
  • Pouchitis / pathology*
  • Proctocolectomy, Restorative / adverse effects*
  • Proctocolectomy, Restorative / methods
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents