Document Detail

Ileal pouches: adaptation and inflammation.
MedLine Citation:
PMID:  9192067     Owner:  NLM     Status:  MEDLINE    
Ileal pouch-anal anastomosis (IPAA) has become the operation of choice following proctocolectomy for ulcerative colitis (UC) and familial adenomatous polyposis. Functioning ileal pouch mucosa undergoes histological changes resembling the colon (colonic metaplasia). The possible role of stasis and luminal factors--bile acids, short-chain fatty acids and bacteria--are discussed. It seems likely that colonic metaplasia is an adaptive response to the new luminal environment in IPAA. Inflammation in the ileal reservoir ('pouchitis') is the most significant late complication in IPAA. It occurs in 20-30% of patients and is virtually confined to those with prior UC. The clinical picture in pouchitis is highly variable; however, it can be easily categorized into three groups. Nevertheless, in most cases it is likely to represent recurrent UC in the ileal pouch. Current treatments and possible preventative strategies for pouchitis have been outlined.
M N Merrett
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Baillière's clinical gastroenterology     Volume:  11     ISSN:  0950-3528     ISO Abbreviation:  Baillieres Clin. Gastroenterol.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-08-04     Completed Date:  1997-08-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8704786     Medline TA:  Baillieres Clin Gastroenterol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  175-93     Citation Subset:  IM    
Gastrointestinal Sciences, Mornington Peninsula Hospital and Monash Medical Centre, Frankston, Victoria, Australia.
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MeSH Terms
Colectomy / methods
Colitis, Ulcerative / surgery*
Postoperative Complications / epidemiology,  etiology,  pathology
Pouchitis* / epidemiology,  etiology,  pathology
Proctocolectomy, Restorative*

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