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Techniques in Coloproctology
Published in: Techniques in Coloproctology 1/2010

01-11-2010

Ileal pouch dysfunction

Authors: V. N. Papadopoulos, A. Michalopoulos, S. Apostolidis

Published in: Techniques in Coloproctology | Special Issue 1/2010

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Abstract

The causes of pouch dysfunction are inflammatory, non-inflammatory and iatrogenic. The most common long-term complication is pouchitis. Diagnosis should be based on clinical symptoms, endoscopic appearance and histologic findings. Ciprofloxacin and metronidazole are the treatment of choice for pouchitis. Fistulae and perianal abscesses should be suspected to be an expression of misdiagnosed Crohn's disease. Strictures are confronted by endoscopic balloon dilatation. Patients who will be refractory to all forms of medical treatment should have surgical treatment such as faecal diversion or pouch revision.
Literature
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Paramythiotis D, Basdanis G, Michalopoulos A, Papadopoulos V et al (2005) Incidence and characteristics of pouchitis after total proctocolectomy. Surg Chron 10:334–341
2.
Meagher AP (1998) J ileal pouch-anal anastomosis for chronic ulcerative colitis: complications and long-term outcome in 1310 patients. Br J Surg 85(6):800–803CrossRefPubMed
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Shen B, Fazio VW, Remzi FH, Lashner BA (2005) Clinical approach to diseases of ileal pouch-anal anastomosis. Am J Gastroenterol 100:2796–2807
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McLaughlin SD, Clark SK, Tekkis PP et al (2008) Review article: restorative proctocolectomy, indications, management of complications and follow-up—a guide for gastroenterologists. Aliment Pharmacol Ther 27:895–909
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Lovegrove RE, Heriot AG, Constantinides V et al (2007) Meta-analysis of short-term and long-term outcomes of J, W and S ileal reservoirs for restorative proctocolectomy. Colorectal Dis 9:310–320
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Penna C, Dozois RR, Tremaine W et al (1996) Pouchitis after ileal pouch-anal anastomosis for ulcerative colitis occurs with increased frequency in patients with associated primary sclerosing cholangitis. Gut 38:234–239
Metadata
Title
Ileal pouch dysfunction
Authors
V. N. Papadopoulos
A. Michalopoulos
S. Apostolidis
Publication date
01-11-2010
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue Special Issue 1/2010
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-010-0630-z

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