title: Postoperative joint symptoms: a risk factor for pouchitis in ulcerative colitis patients.
abstract: BACKGROUND
  The prevalence and significance of joint symptoms appearing in patients with ulcerative colitis (UC) following a colectomy are unclear.
  
  
  OBJECTIVE
  We investigated the relationship between joint symptoms during steroid tapering following an ileal pouch-anal anastomosis (IPAA) and the cumulative risk for developing pouchitis.
  
  
  METHODS
  The medical records of 571 patients who underwent an IPAA with a mucosectomy were retrospectively reviewed to evaluate their joint symptoms. A diagnosis of pouchitis was obtained using the Pouchitis Disease Activity Index (PDAI) and the cumulative risk of pouchitis was estimated using a Kaplan-Meier life table analysis.
  
  
  RESULTS
  Joint symptoms during steroid tapering were reported by 126 (22.0%) of the UC patients and each of those had involvement of the small joints of the hand. The main symptoms were pain and stiffness, especially in the morning. The cumulative risk for developing pouchitis after 10 years was found to be 20% in patients who experienced joint symptoms during steroid tapering and 10% in those without those symptoms (p = 0.001).
  
  
  CONCLUSIONS
  The presence of joint symptoms during steroid tapering is a significant risk factor for the development of pouchitis in patients who have undergone an IPAA for UC.
authors.affiliation: Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeuchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakano
authors.forename: Motoi
authors.initials: M
authors.lastname: Uchino
authors.forename: Masafumi
authors.initials: M
authors.lastname: Noda
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.forename: Takehira
authors.initials: T
authors.lastname: Yamamura
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000209:etiology*; D016737:Proctocolectomy, Restorative; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones