title: Characteristics of extremely early-onset pouchitis after proctocolectomy with ileal pouch-anal anastomosis.
abstract: OBJECTIVE
  This study aims to evaluate the clinical characteristics of patients with postoperative ulcerative colitis developing extremely early-onset pouchitis within 4 weeks of restoration of gastrointestinal continuity.
  
  
  METHODS
  This retrospective study involved 225 consecutive patients from January 2000 to May 2011 who underwent ileal pouch-anal anastomosis for ulcerative colitis with a minimum follow-up of 12 months. Extremely early-onset pouchitis was defined as pouchitis developing within 4 weeks of restoration of gastrointestinal continuity. Patients with pouchitis were divided into extremely early-onset pouchitis and non-extremely early-onset pouchitis groups for comparison.
  
  
  RESULTS
  Of 212 patients who met the inclusion criteria, 62 had pouchitis (29.2 %). Eight (3.8 %) patients developed extremely early-onset pouchitis. There was a significant difference in the dosage of steroid per month just before colectomy between the two groups (P = 0.039). The modified Pouchitis Disease Activity Index score for patients with extremely early-onset pouchitis was higher than in patients with non-extremely early-onset pouchitis (P = 0.0009). The occurrence of extremely early-onset pouchitis was associated with the development of chronic pouchitis (P = 0.0056).
  
  
  CONCLUSIONS
  Extremely early-onset pouchitis may be related to high steroid dosages before colectomy and may be more severe than pouchitis that occurs >4 weeks after restoration of gastrointestinal continuity.
authors.affiliation: Departments of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. nyokkin@clin.medic.mie-u.ac.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okita
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Shimura
authors.forename: Mikio
authors.initials: M
authors.lastname: Kawamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujikawa
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Inoue
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019449:Pouchitis / Q000139:chemically induced / Q000209:etiology*; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D057234:Preoperative Period; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone