["Pouchitis": new routes of research and signification]

"Pouchitis" is clearly disease-related, in that patients with ulcerative colitis are more likely to get the condition after the ileal pouch-anal canal operation than are patients with familial adenomatous polyposis. Moreover, extraintestinal manifestations of colitis may flare up with the onset of pouchitis in colitis patients, and RFD9+ macrophages characteristics of colitis patients are more common in the pouch mucosa of patients with pouchitis than in those without pouchitis. Nonetheless, luminal factors have a role. Some, like bacteria and their products and nonsulfated bile acids, likely aggravate pouchitis, while others, like glutamine, short-chain fatty acids and perhaps calcium, seem to improve symptoms and suppress pouchitis. The inflammatory response may also be suppressed by corticoids, 5-aminosalicylic acid, allopurinol, and the immunosuppressive agents, cyclosporine and FK 506. Nonetheless, the prevention of pouchitis is empiric and imperfect, and the response to treatment of often temporary. The exact cause and the specific cure of pouchitis are still unknown.