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Results for “Pouchitis”

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At least 181 records · Page 10Linked to original sources
PubMed1986

Solitary J-pouch ulcer causing pouchitis-like syndrome.

A 37-year-old man with familial polyposis coli who had undergone restorative proctocolectomy with a J-pouch as an ileal reservoir developed a solitary mucosal ulcer in the reservoir, causing a pouchitis-like syndrome. There was no endoscopic evidence of further inflammatory changes of the mucosa. The ulcer healed and symptoms subsided after six weeks of therapy with metronidazole followed by tetracycline. Possible causal and pathogenic factors are considered and discussed. Association of this patient's lesion with the nonspecific mucosal inflammatory process described in pouchitis is suggested by similar clinical manifestations and outcome.

Adult↗
PubMed2000

Atypical forms of inflammatory bowel disease: microscopic colitis and pouchitis.

Three atypical colitides (and enterides) are collagenous colitis, lymphocytic colitis, and ileal pouchitis. Collagenous and lymphocytic colitis are similar inflammatory bowel disorders of unknown cause with symptoms including chronic watery diarrhea, occurring in middle age. Pouchitis is the most significant long-term complication in patients with ileoanal pouch anastomosis. The clinical and histologic features and management of these entities are discussed.

Journal Article↗
PubMed1991

["Pouchitis" after ileo-anal anastomosis with reservoir].

Pouchitis is the most poorly understood complication of ileoanal anastomosis. The incidence reported in the literature ranges from 7 to 42% as there are no diagnostic criteria. The various clinical symptoms and endoscopic findings raise the possibility that pouchitis is a heterogenous disease, in which the role of bacterial overgrowth and recurrence of inflammatory bowel disease must be clarified.

Acute Disease↗
PubMed1993

["Pouchitis"; histology].

"Pouchitis" is a well recognised complication of restorative proctocolectomy characterised by acute diarrhoea, sometimes with blood, often complicated by incontinence, malaise, arthritis, erythema nodosum and fever. The ileal mucosa is hyperaemic, there may be shallow ulcers and contact bleeding. Biopsies characteristically show villous atrophy, a poly-morphonuclear infiltrate and chronic inflammatory cells, but the histopathological features are often patchy and may be difficult to differentiate from ischaemic ileitis, colonic metaplasia or Crohn's disease. "Pouchitis" is probably due to an overgrowth of intestinal bacteria secondary to stasis but there is some evidence that there may be an ischaemic factor. Most patients respond rapidly to oral metronidazole.

Crohn Disease↗
PubMed1993

[Etiology of "pouchitis"].

"Pouchitis" remains an unsolved problem which affects the lives of significant numbers of patients who have undergone an ileal pouch-anal anastomosis procedure for ulcerative colitis or familial adenomatous polyposis. Conditions which mimic "pouchitis" include overflow incontinence, specific infections, ischemic enteritis, peri-pouch sepsis and Crohn's disease. Current theories of etiology and implications for treatment are examined in this review article.

Bacterial Infections↗
PubMed2001

Medical management of postoperative complications of inflammatory bowel disease: pouchitis and Crohn's disease recurrence.

Surgical intervention is often required for patients with inflammatory bowel disease. Total proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients with ulcerative colitis. The main long-term complication of this surgery is pouchitis, with 10-year cumulative incidence rates between 24% and 46%. For patients with Crohn's disease, postoperative recurrence is a significant problem, with clinical recurrence rates as high as 55% at 5 years and 76% at 15 years. Increasing evidence suggests that postoperative medical therapy has the potential to decrease the risk of postoperative Crohn's disease recurrence.

Crohn Disease↗
PubMed2004

Infliximab therapy in pediatric Crohn's pouchitis.

OBJECTIVE: We describe the prolonged clinical benefit of murine chimeric antitumor necrosis factor (TNF)-alpha monoclonal antibody, infliximab, on pediatric patients with Crohn's disease and ileal pouch anal anastomosis (IPAA). METHODS: A retrospective review of patients originally diagnosed with ulcerative colitis, status post colectomy and IPAA, who developed findings compatible with Crohn's disease was undertaken. Refractory pouchitis developed in all patients as well as protracted symptoms of diarrhea, abdominal pain, joint pain, and incontinence. All patients received infliximab. RESULTS: Four pediatric patients (2 males and 2 females) with mean age of 14.5 years (range 11-18 years) were studied. The development of perianal fistulas in 2 patients, granuloma on biopsy in 1 patient and perianal skin tag in 1 patient, led to a diagnosis change of CD. After failure to respond to antibiotics, aminosalicylates and immunomodulators such as azathioprine and 6-mercaptopurine (6-MP), all patients were treated with infliximab. Patients received infliximab infusions at a dose of 5 mg/kg, initially at weeks 0, 2 and 6 and subsequently at 8 weeks intervals in combination with an immunomodulator drug. All patients showed marked improvement clinically, endoscopically, and histologically. CONCLUSION: Infliximab can be used successfully for the treatment of pediatric patients with Crohn's disease and IPAA who are refractory to conventional therapies.

Adolescent↗
PubMed2004

[Pouchitis, on the basis of a single observation].

The observing of pouchitis at a patient with ulcerative colitis with onset 4 months after the closing of the ileostoma, protecting the reservoir and with good response to metronidazole, was the reason for performing a literature review of the modern problems of this complication. The suspected pre-, intra- and perioperative factors, taking part in its pathogenesis, its clinical features and treatment are reviewed. We share most authors' opinion that this complication probably is connected with the disease.

Adolescent↗
PubMed1994

Hypothesis--pouchitis represents a useful clinical model of ulcerative colitis.

Various mechanisms have been proposed for the aetiology of inflammation in ileal pouches following restorative proctocolectomy. It is proposed that many of these processes may be involved in the pathogenesis of ulcerative colitis, and therefore pouchitis may be used to study pathogenesis and treatment of inflammatory bowel disease in general and, in particular, ulcerative colitis.

Colitis, Ulcerative↗