Document Detail


Diagnosis and treatment of pouchitis.
MedLine Citation:
PMID:  12617884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Total proctocolectomy with ileal pouch-anal anastomosis is the surgical procedure of choice for the management of ulcerative colitis. Pouchitis, a non-specific inflammation of the ileal reservoir, is the most frequent complication that patients experience in the long-term. Diagnosis should be made on the basis of clinical, endoscopic and histological aspects. The Pouchitis Disease Activity Index (PDAI) represents an objective and reproducible scoring system for pouchitis: active pouchitis is defined as a score > or = 7 and remission as a score < 7. About 15% of patients develop a chronic disease. Treatment of pouchitis is empirical, and very few controlled studies have been carried out. Antibiotics, particularly metronidazole and ciprofloxacin, are the treatment of choice. Chronic pouchitis may benefit from a prolonged course of a combination of antibiotics. Highly concentrated probiotics are effective for both prevention of relapses and prevention of pouchitis onset. There is no convincing evidence of the efficacy of other therapeutic agents.
Authors:
Paolo Gionchetti; Cristina Amadini; Fernando Rizzello; Alessandro Venturi; Gilberto Poggioli; Massimo Campieri
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical gastroenterology     Volume:  17     ISSN:  1521-6918     ISO Abbreviation:  Best Pract Res Clin Gastroenterol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-03-05     Completed Date:  2003-07-01     Revised Date:  2006-04-13    
Medline Journal Info:
Nlm Unique ID:  101120605     Medline TA:  Best Pract Res Clin Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  75-87     Citation Subset:  IM    
Affiliation:
University of Bologna, Department of Internal Medicine and Gastroenterology, Policlinico S Orsola, Via Massarenti no 9, 40138 Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Colitis, Ulcerative / therapy
Diagnosis, Differential
Endoscopy, Digestive System
Humans
Pouchitis / diagnosis*,  etiology,  pathology,  therapy*
Probiotics / therapeutic use
Proctocolectomy, Restorative / adverse effects
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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