Clinical approach to diseases of ileal pouch-anal anastomosis.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for ulcerative colitis (UC) patients with medically refractory disease or dysplasia. IPAA significantly improves quality of life in UC patients who require surgery. However, certain inflammatory and noninflammatory diseases can develop after the surgery, including pouchitis, Crohn's disease of the pouch, cuffitis, and irritable pouch syndrome. The etiology and pathogenesis of these disease conditions of IPAA are largely unknown. Accurate diagnosis and classification are important for appropriate management. Endoscopic evaluation is the most important tool for the diagnosis and differential diagnosis.
Shen
Bo
B
Center for Inflammatory Bowel Disease, Department of Gastroenterology/Hepatology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Fazio
Victor W
VW
Remzi
Feza H
FH
Lashner
Bret A
BA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects*; D003113:Colonoscopy / Q000379:methods; D003424:Crohn Disease / Q000188:drug therapy / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D019449:Pouchitis / Q000188:drug therapy / Q000473:pathology*; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents