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What is Pouchitis?

By Nat Robinson
Updated May 17, 2024
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Individuals with diseases of the colon and rectum sometimes need to have these organs removed. In many cases, removing the diseased organs is the only way to treat the illness. Commonly, when the colon and/or rectum are removed, individuals are fitted with an internal pouch, commonly called an ileal pouch or ileal pouch-anal anastomosis (IPAA). The pouch will be used to collect waste and remove it from the body. Sometimes, the internal pouch can become inflamed, resulting in a condition known as pouchitis.

Generally, individuals with pouchitis received their internal pouch due to an inflammatory bowel disease. In many cases, the individual may have ulcerative colitis. This type of disease can affect the colon as well as the rectum and can cause inflammation and ulcers to form in the organs. An ileal pouch may also be placed due to Crohn's disease, which also causes inflammation in organs of the digestive tract. Often, an inherited colon polyp disorder known as familial adenomatous polyposis (FAP) can lead to the need of an ileal pouch.

Pouchitis symptoms can be very similar to those of ulcerative colitis and Crohn's diseae. Many individuals may experience abdominal pain, a fever, cramps and nausea or vomiting. Diarrhea is also a very common symptom. Frequently, pouchitis can produce an abnormal frequency of bowel movements. Some of the more serious complications can include bleeding from the anus, pain in the joints and dehydration.

This illness is not particularly uncommon in individuals with an internal pouch of this nature. Some individuals may develop more than one case of pouchitis. When a person with an ileal pouch starts to experience upsetting digestive symptoms, he or she should contact a physician and be seen for an evaluation. The doctor will complete a physical exam and will generally follow up with an internal examination of the digestive system. He or she may order a computerized tomography (CT) scan or magnetic resonance imaging test to view the internal structures.

Antibiotics are typically used to treat pouchitis. Most cases of the inflammation clears after patients complete a full antibiotic regimen. Doctors may have to use a different type of antibiotic if the inflammation quickly reoccurs. Other commonly used types of medicines include probiotics and immunosuppressives.

Most cases of pouchitis are acute. This means the inflammation may appear and subside within a short amount of time. It is possible though for an individual to develop a chronic or ongoing case of the condition. If this happens, more invasive measures may be taken to treat the inflammation, such as removing the internal pouch.

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