Pouchitis

Acute INFLAMMATION in the INTESTINAL MUCOSA of the continent ileal reservoir (or pouch) in patients who have undergone ILEOSTOMY and restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).

Also Known As:

Networked: 985 relevant articles (175 outcomes, 178 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ulcerative Colitis
2.	Crohn Disease (Crohn's Disease)
3.	Diarrhea
4.	Colitis
5.	Inflammation (Inflammations)

Experts

1.	Shen, Bo: 77 articles (01/2022 - 04/2002)
2.	Remzi, Feza H: 26 articles (03/2016 - 04/2002)
3.	Fazio, Victor W: 22 articles (03/2012 - 04/2002)
4.	Gionchetti, Paolo: 17 articles (01/2021 - 02/2003)
5.	Rizzello, Fernando: 15 articles (01/2021 - 02/2003)
6.	Barnes, Edward L: 14 articles (12/2022 - 01/2019)
7.	Herfarth, Hans H: 14 articles (12/2022 - 09/2015)
8.	Dotan, Iris: 14 articles (01/2022 - 01/2009)
9.	Lopez, Rocio: 14 articles (01/2020 - 01/2006)
10.	Campieri, M: 14 articles (11/2012 - 08/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pouchitis:

1.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2015 - "The highly concentrated probiotic mixture VSL#3 has been shown to be effective in prevention of pouchitis onset and in maintaining antibiotic-induced remission." 01/01/2017 - "Antibiotics significantly induced remission in patients with chronic pouchitis with 74% remission rate (95% CI:56-93%), (P < 0.001). " 10/01/2013 - "Pouchitis Disease Activity Index (PDAI) was significantly improved after antibiotic and probiotic supplementation. " 01/01/2004 - "The once daily high dose probiotic VSL#3 is effective in maintaining antibiotic introduced remission for at least a year in patients with recurrent or refractory pouchitis. " 10/01/2002 - "Three patients (23%) had pouchitis, all treated successfully with oral antibiotics. "
2.	Metronidazole (Metric)FDA LinkGeneric 05/01/1994 - "In conclusion, topical application of small doses of metronidazole relieved symptoms in most cases of pouchitis and was well tolerated, even as long-term treatment." 01/01/2022 - "For chronic pouchitis, metronidazole followed by probiotics was statistically significant and effective treatments in inducing remission although metronidazole had the highest adverse events. " 12/01/2001 - "This study was undertaken to document the incidence of pouchitis at the Edinburgh Royal Infirmary and to assess outcome of treatment with metronidazole. " 06/01/1994 - "Double-blind crossover trial of metronidazole versus placebo in chronic unremitting pouchitis." 04/01/1993 - "Six of the patients with pouchitis underwent repeat studies after 1-month treatment with metronidazole, 400 mg three times daily. "
3.	Ciprofloxacin (Cipro)FDA LinkGeneric 03/30/2023 - "All the patients received concomitant ciprofloxacin from weeks 1 to 4. The primary end point was modified Pouchitis Disease Activity Index (mPDAI)-defined remission (an mPDAI score of ≤4 and a reduction from baseline of ≥2 points in the mPDAI total score; scores range from 0 to 12, with higher scores indicating more severe pouchitis) at week 14. " 01/01/2009 - "Fourteen consecutive patients with symptomatic pre-pouch ileitis were treated with ciprofloxacin 500 mg b.d. " 09/28/2006 - "Firstly we used ciprofloxacin to treat pouchitis. " 11/01/2001 - "Ciprofloxacin should be considered as one of the first-line therapies for acute pouchitis." 10/01/1993 - "Therapy of pouchitis was usually carried out with ciprofloxacin 500 mg by mouth everyday or twice a day. "
4.	Infliximab (Remicade)FDA Link 02/01/2023 - "All not naïve patients who had previously been treated with Infliximab (n = 9) had adverse reactions when the same drug was given for pouchitis. " 07/01/2020 - "Here we report a rare case of chronic refractory pouchitis-associated PG successfully treated with infliximab (IFX). " 11/01/2013 - "One year infliximab administration is associated with a long term benefit in patients with chronic refractory pouchitis following IPAA for UC." 11/01/2013 - "Seven patients with chronic refractory pouchitis diagnosed by clinical, endoscopic and histological criteria received infliximab 5 mg/kg at 0, 2, and 6 weeks and thereafter every 2 months for 1 year. " 11/01/2013 - "Long term benefit of one year infliximab administration for the treatment of chronic refractory pouchitis."
5.	Rifaximin (L 105)FDA Link 10/01/2007 - "A larger trial would be required to determine if rifaximin is effective for the treatment of active pouchitis. " 10/01/2007 - "We performed a placebo-controlled pilot trial to evaluate the efficacy and safety of rifaximin in patients with active pouchitis. " 10/01/2007 - "Eighteen patients with active pouchitis were randomized to receive oral rifaximin 400 mg or placebo 3 times daily for 4 weeks. " 10/01/2007 - "Rifaximin for the treatment of active pouchitis: a randomized, double-blind, placebo-controlled pilot study." 01/01/2006 - "Preliminary data suggest that rifaximin may be beneficial in the treatment of active ulcerative colitis (and pouchitis), mild to moderate CD as well as prevention of post-operative recurrence of CD."
6.	Budesonide (Pulmicort)FDA LinkGeneric 10/01/2008 - "Oral budesonide CIR capsules may be an option to induce remission in active chronic refractory pouchitis. " 05/15/2007 - "To evaluate the efficacy of oral budesonide in inducing remission and improving quality of life in patients with chronic refractory pouchitis. " 01/01/2018 - "[Recalcitrant pouchitis treated by budesonide foam:a case report]." 10/01/2008 - "[Oral budesonide in the treatment of chronic refractory pouchitis]." 05/15/2007 - "Oral budesonide in the treatment of chronic refractory pouchitis."
7.	vedolizumabIBA 01/01/2019 - "Vedolizumab is safe and effective in the management of CD of the pouch and chronic pouchitis. " 01/01/2019 - "Efficacy of Vedolizumab for Refractory Pouchitis of the Ileo-anal Pouch: Results From a Multicenter US Cohort." 01/01/2020 - "a MEDLINE and Web of Science search of all studies published in English until March 17, 2019 was conducted using the terms "vedolizumab and pouchitis". " 12/01/2023 - "Vedolizumab Earning Its Place as a Treatment for Chronic Pouchitis." 08/01/2023 - "Apart from vedolizumab and the De Simone formulation, the effects of other medical interventions for pouchitis are uncertain."
8.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 01/01/2017 - "In this study, the association between serum tumor necrosis factor-alpha (TNF-α) levels and refractory pouchitis was evaluated. " 08/01/2020 - "Anti-tumor necrosis factor-α (TNF-α) therapy was administered, which led to some improvement; however, pouchitis recurred. " 11/01/2019 - "However, on multivariable analysis, only anti-tumor necrosis factor therapy was an independent predictor for pouchitis (p = 0.05). " 06/01/2008 - "Because the patient had received tumor necrosis factor (TNF)-alpha inhibitor therapy for refractory pouchitis, a diagnosis of TNF-alpha inhibitor-induced lupus-like syndrome was considered. " 11/01/2019 - "In a large cohort of patients undergoing IPAA for ulcerative colitis with at least a 5-year follow-up, anti-tumor necrosis factor exposure was the only independent risk factor for the development of pouchitis. "
9.	BismuthIBA 08/01/1997 - "Our findings suggest that bismuth carbomer enemas are safe and effective in achieving and maintaining remission in patients with treatment-resistant chronic pouchitis." 08/01/1997 - "To determine the safety and efficacy of bismuth carbomer enemas in achieving and maintaining remission in treatment-resistant chronic pouchitis. " 08/01/1997 - "Long-term efficacy of bismuth carbomer enemas in patients with treatment-resistant chronic pouchitis." 12/01/1997 - "In this study, the efficacy and safety of bismuth carbomer foam enemas for active chronic pouchitis was determined in a placebo-controlled trial. " 12/01/1997 - "Bismuth carbomer foam enemas for active chronic pouchitis: a randomized, double-blind, placebo-controlled trial."
10.	carbomerIBA 08/01/1997 - "Our findings suggest that bismuth carbomer enemas are safe and effective in achieving and maintaining remission in patients with treatment-resistant chronic pouchitis." 08/01/1997 - "To determine the safety and efficacy of bismuth carbomer enemas in achieving and maintaining remission in treatment-resistant chronic pouchitis. " 08/01/1997 - "Long-term efficacy of bismuth carbomer enemas in patients with treatment-resistant chronic pouchitis." 12/01/1997 - "In this study, the efficacy and safety of bismuth carbomer foam enemas for active chronic pouchitis was determined in a placebo-controlled trial. " 12/01/1997 - "Bismuth carbomer foam enemas for active chronic pouchitis: a randomized, double-blind, placebo-controlled trial."

Therapies and Procedures

1.	Therapeutics 01/01/2020 - "Probiotics are most effective in pouchitis, and may have a role in the initial therapy and maintenance of remission in mild UC; the probiotic cocktail VSL#3 has been the most widely studied. " 10/01/2003 - "There are very few such published randomized clinical trials, but some data exist that possibly show an efficacy of probiotics as maintenance therapy in chronic relapsing pouchitis. " 01/01/2004 - "Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis." 01/01/2018 - "The rate of remission after anti-TNF induction therapy seemed to be higher in CD-like complications of the pouch 0.64 (95%CI[0.5-0.77]; I2 = 0.18), compared to refractory pouchitis 0.10 (95%CI [0.00-0.35]; I2 = 0.00) (P = 0.06), whereas no such difference appeared after long-term maintenance therapy 0.57 (95%CI[0.43-0.71]; I2 = 0.32) and 0.37 (95%CI [0.14-0.62]; I2 = 0.47), respectively (P = 0.57). " 09/01/2011 - "The strongest data suggest that antimicrobial therapy is an effective first-line treatment for acute pouchitis, and VSL#3 may be effective for prevention of recurrence."
2.	Restorative Proctocolectomy 07/01/2004 - "Although most patients report a good functional outcome and significant improvement in their quality of life after ileal pouch-anal anastomosis, pouchitis remains the most common long-term complication. " 05/01/2003 - "Treatment with VSL#3 is effective in the prevention of the onset of acute pouchitis and improves quality of life of patients with ileal pouch-anal anastomosis." 08/31/2006 - "Initial clinical studies have also provided promising results regarding the efficacy of VSL#3 in preventing pouchitis immediately following proctocolectomy." 05/01/2001 - "The ileal pouch anal anastomosis is a safe and effective procedure but is also associated with pouchitis, small bowel obstruction, and incontinence. " 01/01/2023 - "The efficacy of probiotics on the prevention of pouchitis for patients after ileal pouch-anal anastomosis: A meta-analysis."
3.	Ileostomy 09/01/2008 - "For improved QOL in the future, pouch surgery should have a lower incidence of diverting ileostomy and result in fewer bowel movements and a lower incidence of soiling, with optimal management of pouchitis." 07/01/2003 - "The effective treatment for this chronic resistant pouchitis is to remove the ileal pouch and perform the permanent ileostomy. " 05/01/2008 - "The probiotic VSL#3 prevents pouchitis if started within a week of ileostomy closure and maintains remission following antibacterial treatment in patients with refractory or recurrent pouchitis. " 01/01/1994 - "This study was undertaken to assess the electron microscopic and microbiologic findings in tissue biopsy samples from patients with pouchitis and to compare them with findings in patients with normal pouches, conventional ileostomies, and normal ileum. " 01/01/2023 - "There were no significant differences in incidence rates (21% vs. 23.6%, p = 0.83), time to developing CDLPC from ileostomy closure (22.3 vs. 23.8 months; p = 0.81), pouchitis rates (23.6% vs. 27.2%; p = 0.68), or pouch failure rates (5.2 vs. 7.2; p = 0.71). "
4.	Enema (Enemas) 07/01/1998 - "Of 37 patients who underwent routine postoperative contrast enemas, 33 (89%) had normal studies, three (8%) had clinically silent leaks (including two blind-ending tracks from the ileoanal anastomosis and one from the pouch), and one (3%) had pouchitis. " 10/01/2020 - "Nine patients with chronic pouchitis were allocated to treatment with FMT delivered by enema from five faecal donors for 14 consecutive days in a 6-month prospective, open-label, single-centre cohort pilot study. " 04/01/2020 - " and methods: Nine adult patients with chronic pouchitis were included and allocated to 14 days FMT by enemas from five faecal donors, with a 6-month follow-up. " 10/01/2008 - "Topical enemas for ulcerative colitis have demonstrated some effect in secondary outcomes, and initial studies in pouchitis are promising. " 02/01/2004 - "In an open-label, uncontrolled study, 12 patients with chronic, unremitting pouchitis were treated with 240 mg alicaforsen antisense enema nightly for 6 weeks. "
5.	Fecal Microbiota Transplantation 04/01/2019 - "The efficacy of fecal microbiota transplantation for patients with chronic pouchitis: A case series." 10/20/2021 - "The fecal microbiota transplantation treatment regime used in our study was not effective in the treatment of chronic pouchitis. " 10/20/2021 - "This was a single-center, double-blinded, parallel group trial comparing donor fecal microbiota transplantation with placebo (autologous transplant) in chronic pouchitis. " 10/20/2021 - "The aim of this trial was to investigate the efficacy and safety of fecal microbiota transplantation in the treatment of chronic pouchitis. " 01/01/2020 - "Fecal microbiota transplantation has also been reported to have encouraging preliminary results in small studies and case series for the treatment of chronic pouchitis. "