Pouchitis following pelvic pouch operation for ulcerative colitis

Ståhlberg, Dagny; Gullberg, Kjell; Liljeqvist, L; Hellers, G; Löfberg, Robert

doi:10.1007/bf02054692

Cited by 243 publications

(140 citation statements)

References 19 publications

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“…Also, those with extensive disease were the lightest smokers, whereas those with healthy colons were the heaviest smokers. Finally, current smokers have a lower incidence of pouchitis following coloproctectomy with ileal reservoir when compared with non-smokers [30,31] . In contrast, intriguing new data by Aldhous et al [29] showed that current and non-smokers had an almost identical age at onset (31.1 vs 29.4 years) and this was delayed only in ex-smokers (46.5 years).…”

Section: Effect Of Smoking and Its Cessation On Clinical Course And Ementioning

confidence: 93%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹,

Szamosi²,

Lakatos³

2007

WJG

133

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Smoking is an important environmental factor in inflammatory bowel disease (IBD), having different effects in ulcerative colitis (UC) and Crohn's disease (CD). A recent meta-analysis partially confirmed previous findings that smoking was found to be p r o t e c t i v e a g a i n s t u l c e r a t i v e c o l i t i s a n d , a f t e r onset of the disease, might improve its course, d e c r e a s i n g t h e n e e d f o r c o l e c t o m y . H o w e v e r , smoking increases the risk of developing Crohn's disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn's disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

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Section: Effect Of Smoking and Its Cessation On Clinical Course And Ementioning

confidence: 93%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹,

Szamosi²,

Lakatos³

2007

WJG

133

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“…As the majority of patients develop acute pouchitis within the first year after IPAA [65] , VSL#3® containing 4 strains of Lactobacillus, 3 Bifidobacterium species, and Streptococcus www.wjgnet.com salivarius subsp. Thermophillus was evaluated for the primary prophylaxis for the initial episode of pouchitis.…”

Section: Treatmentmentioning

confidence: 99%

Pouchitis

Yu¹,

Shao²,

Shen³

2007

WJG

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While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery, complications can occur. Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute, antibioticresponsive type to chronic antibiotic-refractory entity. Accurate diagnosis using a combined assessment of symptoms, endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease. The majority of patients respond favorably to antibiotic therapy. However, management of chronic antibiotic-refractory pouchitis remains a challenge.

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“…For the maintenance of remission and the prevention of chronic pouchitis, VSL#3 probiotic proved to be more effective than placebo. Chronic pouchitis which requires maintenance suppressive therapy and common leads to pouch failure has been reported in approximately 9% to 20% of all surgeries [11]. Refractory pouchitis may significantly influence the patients' quality of life.…”

Section: Discussionmentioning

confidence: 99%

Management of Patients with Ulcerative Colitis after Proctocolectomy:Pouchitis is a Real Danger

Molnár

Farkas²,

Nagy³

et al. 2011

J Gastrointest Dig Syst

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Pouchitis develops in about 50% of the patients with ulcerative colitis (UC) undergoing colectomy. Aim:The aim of this study was to evaluate the frequency of pouchitis, to determine risk factors and to assess the efficacy of infliximab in refractory pouchitis.Patients and Methods: 76% of the 46 UC patients requiring colectomy underwent ileal pouch-anal anastomosis (IPAA) procedure. Demographic, clinical and therapeutic parameters were compared between patients who did and did not develop pouchitis and between those with pouchitis responding or being refractory to the conservative therapy.Results: 40% of the patients developed pouchitis. Six patients received infliximab therapy. Extraintestinal manifestation and non smoking was characteristic for refractory pouchitis.Discussion: Pouchitis developed in 40% of our patients undergoing IPAA. The development of pouchitis seems to be predisposed by frequent preoperative hospitalization. The earlier onset of pouchitis seems to be a prognostic factor for the unsuccessful conservative treatment and the need for biological therapy.

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Pouchitis following pelvic pouch operation for ulcerative colitis

Abstract: The risk for pouchitis was highest during the initial six-month period. Cumulative risk leveled off after two years but was substantial (51 percent) at four years. Less than 10 percent of patients had severe, chronic pouchitis, and only two patients (1.3 percent) had their pouches removed.

Cited by 243 publications

References 19 publications

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Pouchitis

Management of Patients with Ulcerative Colitis after Proctocolectomy:Pouchitis is a Real Danger

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