Diagnosis and treatment of pouchitis |
| |
Authors: | Gionchetti Paolo Amadini Cristina Rizzello Fernando Venturi Alessandro Poggioli Gilberto Campieri Massimo |
| |
Institution: | University of Bologna, Department of Internal Medicine and Gastroenterology, Policlinico S Orsola, Via Massarenti no 9, 40138 Bologna, Italy. |
| |
Abstract: | Total proctocolectomy with ileal pouch-anal anastomosis is the surgical procedure of choice for the management of ulcerative colitis. Pouchitis, a non-specific inflammation of the ileal reservoir, is the most frequent complication that patients experience in the long-term. Diagnosis should be made on the basis of clinical, endoscopic and histological aspects. The Pouchitis Disease Activity Index (PDAI) represents an objective and reproducible scoring system for pouchitis: active pouchitis is defined as a score > or = 7 and remission as a score < 7. About 15% of patients develop a chronic disease. Treatment of pouchitis is empirical, and very few controlled studies have been carried out. Antibiotics, particularly metronidazole and ciprofloxacin, are the treatment of choice. Chronic pouchitis may benefit from a prolonged course of a combination of antibiotics. Highly concentrated probiotics are effective for both prevention of relapses and prevention of pouchitis onset. There is no convincing evidence of the efficacy of other therapeutic agents. |
| |
Keywords: | |
本文献已被 PubMed 等数据库收录! |
|