POUCHITIS: A TRIDIMENSIONAL VIEW

Francesco Carini, Giovanni Tomasello, Francesco Cappello, Salvatore Marasà, Dario Raimondo, Stefano Mandalà, Giancarlo Pompei, Aroldo Gabriele Rizzo, Emanuele Sinagra, Guido Martorana, Francesca Rossi, Stefano Mandalà, Dario Raimondo, Giovanni Tomasello, Stefano Mandalà, Pier Enrico Marchesa, Francesco Cappello

Research output: Contribution to journalArticlepeer-review

Abstract

The preferred surgical treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP) is represented by proctocolectomy with ileal pouch-anal anastomosis (IPAA). However, patients with UYC who have undergone IPAA are prone to develop several complications, which include surgery related/mecchanical complications; inflammatory or infectious disoreders; dysplasia or neoplasia; and systemic or metabolic disorders. Pouchitis, which is defined as the acute and/or chronic inflammation of the ileal reservoir, represent the most common long-term adverese sequela after IPAA. Gut microbiota play a pivotal role in the initiation and disease progression of pouchitis. Pouchitis can be classified according to the activity of the disease, the duration of the symptoms, the pattern of the disease or response to antibiotic therapy. Patients with IPAA for UC tend to experience a variety of symptoms that may eventually lead to pouch excision thereby necessitating the construction of a permanent ileostomy. To date, the ethiology, the diagnosis and the medical management of pouchitis represent a clinical challenge. In fact pouchitis range from a disease with an acute antibiotic-responsive presentation to a chronic antibiotic-refractory form, with subsequent different disease mechanism and clinical course. A tridimensional and multidisciplinar approach, including endoscopy, histology, and laboratory testing is widely helpful to identify the diferent phenotypes of the disease and to manage correctly its treatment.
Original languageEnglish
Pages (from-to)315-322
Number of pages8
JournalProgress in Nutrition
Volume18
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Food Science
  • Nutrition and Dietetics

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