Second European evidence-based consensus on the diagnosis and management of ulcerative colitis Part 3: Special situations

Abstract

Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the
\nprocedure of choice for most patients with ulcerative colitis
\n(UC) requiring colectomy. Pouchitis is a non-specific inflammation
\nof the ileal reservoir and the most common complication
\nof IPAA in patients with UC. Its frequency is related to the
\nduration of follow up, occurring in up to 50% of patients 10 years
\nafter IPAA in large series from major referral centres.1–9 The
\ncumulative incidence of pouchitis in patients with an IPAA for
\nfamilial adenomatous polyposis is much lower, ranging from 0 to
\n10%. Reasons for the higher frequency of pouchitis in UC
\nremain unknown. Whether pouchitis more commonly develops
\nwithin the first years after IPAA or whether the risk continues to
\nincrease with longer follow up remains undefined.