Management of Patients with Ulcerative Colitis after Proctocolectomy:Pouchitis is a Real Danger
Tamás Molnár*, Klaudia Farkas, Ferenc Nagy, Zoltán Szepes and Tibor Wittmann
First Department of Medicine, University of Szeged, Szeged, Hungary
- *Corresponding Author:
- Tamás Molnár
First Department of Medicine
University of Szeged, H-6720
Korányi fasor 8, Szeged, Hungary
E-mail: [email protected]
Received date: September 12, 2011; Accepted date: November 14, 2011; Published date: November 16, 2011
Citation: Molnár T, Farkas K, Nagy F, Szepes Z, Wittmann T (2011) Management of Patients with Ulcerative Colitis after Proctocolectomy: Pouchitis is a Real Danger. J Gastrointest Dig Syst 1:102. doi:10.4172/2161-069X.1000102
Copyright: © 2011 Molnár T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Pouchitis develops in about 50% of the patients with ulcerative colitis (UC) undergoing colectomy.
Aim: The aim of this study was to evaluate the frequency of pouchitis, to determine risk factors and to assess the efficacy of infliximab in refractory pouchitis.
Patients and Methods: 76% of the 46 UC patients requiring colectomy underwent ileal pouch-anal anastomosis (IPAA) procedure. Demographic, clinical and therapeutic parameters were compared between patients who did and did not develop pouchitis and between those with pouchitis responding or being refractory to the conservative therapy.
Results: 40% of the patients developed pouchitis. Six patients received infliximab therapy. Extraintestinal manifestation and non smoking was characteristic for refractory pouchitis.
Discussion: Pouchitis developed in 40% of our patients undergoing IPAA. The development of pouchitis seems to be predisposed by frequent preoperative hospitalization. The earlier onset of pouchitis seems to be a prognostic factor for the unsuccessful conservative treatment and the need for biological therapy.