Pouchitis Following Ileal Pouch Anal Anastomosis

Pouchitis is the most common complication resulting from a restorative ileal pouch anastomosis following a total colectomy for management of ulcerative colitis or familial adenomatous polyposis. The etiology of pouchitis is unknown but it is presumed to be related to a change in the intestinal microflora in conjunction with an altered immune response in the ileal mucosa in genetically susceptible individuals. The use of antibiotics to induce remission and probiotics to prevent occurrence and maintain remission has been the mainstay of empirical therapy that has gained clinical research support. The majority of patients with an ileal pouch anal anastomosis enjoys a quality of life comparable to the general population, though pouchitis may have a negative effect for some.