Frequent passing of stools (poo).
- Bloody diarrhea.
- Urgency when passing stools.
- Discomfort while passing stools.
- Blood loss and dehydration resulting from frequent
passing of stools.
Sometimes pain in area of inflammation.
Causes and likelihood of pouchitis
have been a variety of mechanisms suggested for
pouchitis, though the cause of the disease is still
unknown. Pouchitis becomes a progressively more likely
side-effect of an ileal pouch as time passes. The
likelihood of pouchitis, one year after a pouch is
surgically created is 15% of patients, after five years
this increases to 33% of patients and then around 50% of
patients are likely to suffer after ten years.
Testing for Pouchitis
Pouch patients can be assessed for pouchitis with an
endoscopy (telescope inserted into the anus). Pouchitis
sufferers usually have a reddened pouch mucosa, loss of
normal vascular pattern, a mucosa that bleeds when
touched, and sometimes ulcers in the pouch. Biopsies
(tissue samples) show evidence of inflammatory cells in
the lining the pouch.
There is presently no
approved treatment for pouchitis.
line treatment is usually with antibiotics, specifically
with ciprofloxacin and metronidazole. Administration of
antibiotics over a prolonged period can cause various
side effects limiting their use.
Other therapies which have been shown to be effective in
randomised clinical trials include probiotic therapy.
are a number of other drugs used to control an episode
of pouchitis and their use depends on the severity of
the flare up. These may be delivered using enemas
applied directly into the pouch through the anus or may
be given as tablets or liquids taken by mouth. Some
drugs are given by injection or infusion in to a vein or
under the skin.
What to expect
is no known cure for pouchitis, and as the disease
becomes progressively more likely in pouch patients over
time, some challenges can be expected.
Rarely, where pouchitis is chronic and does not respond
to treatment, it may be necessary to perform another
surgical operation. This may be to divert stool away
from the pouch, to allow the pouch to rest, or in severe
cases to remove the pouch completely. When this happens
a patient is given a temporary or permanent ileostomy
depending on whether the pouch is being rested or
removed. An ileostomy is where the ileal tissue is drawn
out of the front of the belly or abdomen to receive the
bowel contents in to a plastic bag called an ileostomy
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