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Published on: December 17, 2011
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Review article: the pathogenesis of pouchitis
K M Schieffer1, E D Williams2, G S Yochum1,3
1Department of Surgery, Division of Colon and Rectal Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Alimentary Pharmacology & Therapeutics
|August 25, 2016
Summary
Pouchitis, inflammation of the ileal pouch, is complex and likely results from a combination of immune system dysregulation and gut bacteria interactions, not a single cause.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Microbiome Research
Background:
- Ileal pouch-anal anastomosis is a surgery for ulcerative colitis and familial adenomatous polyposis.
- Pouchitis, or ileal pouch inflammation, affects 5-35% of ulcerative colitis patients and 0-11% of familial adenomatous polyposis patients.
Purpose of the Study:
- To comprehensively analyze research on pouchitis pathogenesis.
- To identify promising research areas for understanding and managing ileal pouchitis.
Main Methods:
- Review of manuscripts published between 1981 and 2015.
- Analysis of hypotheses and supporting evidence for pouchitis pathogenic mechanisms.
Main Results:
- Pouchitis pathogenesis is not fully understood.
- Proposed mechanisms include UC recurrence, dysbiosis, nutrient deprivation, ischemia, genetic susceptibility, and immune dysregulation.
- No single factor adequately explains pouchitis.
Conclusions:
- Pouchitis is a complex disorder, similar to inflammatory bowel disease.
- Likely caused by a combination of host inflammatory dysregulation and luminal microbiota interactions.
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