Treatment of pouchitis, Crohn's disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium.

TitleTreatment of pouchitis, Crohn's disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium.
Publication TypeJournal Article
Year of Publication2022
AuthorsShen B, Kochhar GS, Rubin DT, Kane SV, Navaneethan U, Bernstein CN, Cross RK, Sugita A, Schairer J, Kiran RP, Fleshner P, McCormick JT, D'Hoore A, Shah SA, Farraye FA, Kariv R, Liu X, Rosh J, Chang S, Scherl E, Schwartz DA, Kotze PGustavo, Bruining DH, Philpott J, Abraham B, Segal J, Sedano R, Kayal M, Bentley-Hibbert S, Tarabar D, El-Hachem S, Sehgal P, Picoraro JA, Vermeire S, Sandborn WJ, Silverberg MS, Pardi DS
JournalLancet Gastroenterol Hepatol
Volume7
Issue1
Pagination69-95
Date Published2022 01
ISSN2468-1253
KeywordsAcute Disease, Anti-Bacterial Agents, Anti-Inflammatory Agents, Biological Products, Chronic Disease, Colonic Pouches, Consensus, Constriction, Pathologic, Crohn Disease, Cutaneous Fistula, Gastrointestinal Agents, Humans, Intestinal Fistula, Intestinal Polyps, Maintenance Chemotherapy, Pouchitis, Recurrence, Risk Factors, Secondary Prevention, Tumor Necrosis Factor-alpha
Abstract

Pouchitis, Crohn's disease of the pouch, cuffitis, polyps, and extraintestinal manifestations of inflammatory bowel disease are common inflammatory disorders of the ileal pouch. Acute pouchitis is treated with oral antibiotics and chronic pouchitis often requires anti-inflammatory therapy, including the use of biologics. Aetiological factors for secondary pouchitis should be evaluated and managed accordingly. Crohn's disease of the pouch is usually treated with biologics and its stricturing and fistulising complications can be treated with endoscopy or surgery. The underlying cause of cuffitis determines treatment strategies. Endoscopic polypectomy is recommended for large, symptomatic inflammatory polyps and polyps in the cuff. The management principles of extraintestinal manifestations of inflammatory bowel disease in patients with pouches are similar to those in patients without pouches.

DOI10.1016/S2468-1253(21)00214-4
Alternate JournalLancet Gastroenterol Hepatol
PubMed ID34774224
Grant ListP30 DK120515 / DK / NIDDK NIH HHS / United States

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