Pouchitis

Overview
Pouchitis is inflammation of the ileal pouch, which is created in the management of patients with ulcerative colitis, indeterminate colitis, or, rarely, other colitides.

Patients with pouchitis typically present with bloody diarrhea, urgency in passing stools, or discomfort while passing stools. Rarely, pain can occur with pouchitis.

Endoscopy in patients with pouchitis usually reveals erythematous pouch mucosa, loss of pseudocolonic vaculature or other architecture, and friability of the mucosa. Biopsies show evidence of inflammatory cells or red blood cells in the lamina propria.

Pouchitis is usually treated with antibiotics, and specifically usually with ciprofloxacin and metronidazole. In refractory cases, probiotics such as VSL-3 and Bio-K+ may be useful.