Dietary intake in patients with ileal pouch-anal anastomosis: a cross-sectional comparative study

Ileal pouch-anal anastomosis (IPAA) is associated with good long-term outcomes, yet pouchitis remains a common complication. Although antibiotics are first-line therapy, recurrent disease often leads to repeated use with declining efficacy. Dietary interventions have shown promise, but evidence and consensus remain limited. The aim of this study was to compare dietary intake between IPAA patients with chronic pouchitis, IPAA patients with a normally functioning pouch, and healthy controls.

This cross-sectional study recruited participants between November 2017 and October 2022. Participants were divided into 3 groups: patients with chronic pouchitis, patients with a normally functioning pouch, and healthy controls with an intact colon. Dietary intake over the previous 12 months was assessed using a food frequency questionnaire. Foods were categorized into groups and reported as servings per week.

The study included 30 participants with chronic pouchitis, 30 with a normally functioning pouch, and 82 healthy controls. Compared with the normal pouch function group, participants in the chronic pouchitis group consumed significantly more refined grains (mean difference [MD] 3.0; P = .045) and chocolate and candy (MD 2.5; P = .011). Compared with healthy controls, the chronic pouchitis group had a higher intake of sweets (MD 5.5; P = .001), refined grains (MD 3.8; P = .006), crispbread (MD 5.0; P < .001), and chocolate and candy (MD 2.6; P = .007).

Dietary intake was generally similar between groups, but patients with chronic pouchitis reported higher consumption of starchy and sugar-rich foods. This dietary pattern may be associated with pouchitis, highlighting the need for interventional studies to assess causality.