1. Treatment of pouchitis, Crohn's disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium
- Author
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Mark S. Silverberg, Udayakumar Navaneethan, André D'Hoore, Severine Vermeire, Jason Schairer, Joseph A Picoraro, Sandra El-Hachem, Sunanda V. Kane, Revital Kariv, Ellen Scherl, Samir A. Shah, Bincy Abraham, Gursimran Kochhar, Akira Sugita, Dino Tarabar, Jessica Philpott, Raymond K. Cross, Paulo Gustavo Kotze, Shannon Chang, Stuart Bentley-Hibbert, David A. Schwartz, Darrell S. Pardi, Bo Shen, Xiuli Liu, Maia Kayal, David T. Rubin, Ravi P. Kiran, Francis A Farraye, Rocio Sedano, Jonathan Segal, James McCormick, Philip Fleshner, Joel R. Rosh, Charles N. Bernstein, William J. Sandborn, David H. Bruining, and Priya Sehgal
- Subjects
medicine.medical_specialty ,Consensus ,medicine.drug_class ,Cutaneous Fistula ,Antibiotics ,Anti-Inflammatory Agents ,Colonic Pouches ,Constriction, Pathologic ,Disease ,Pouchitis ,Gastroenterology ,Inflammatory bowel disease ,Maintenance Chemotherapy ,Crohn Disease ,Gastrointestinal Agents ,Recurrence ,Risk Factors ,Internal medicine ,Intestinal Fistula ,Secondary Prevention ,medicine ,Humans ,Biological Products ,Crohn's disease ,Hepatology ,medicine.diagnostic_test ,Tumor Necrosis Factor-alpha ,business.industry ,Intestinal Polyps ,medicine.disease ,digestive system diseases ,Anti-Bacterial Agents ,Endoscopy ,stomatognathic diseases ,Acute Disease ,Chronic Disease ,Etiology ,Pouch ,business - Abstract
Summary Pouchitis, Crohn's disease of the pouch, cuffitis, polyps, and extraintestinal manifestations of inflammatory bowel disease are common inflammatory disorders of the ileal pouch. Acute pouchitis is treated with oral antibiotics and chronic pouchitis often requires anti-inflammatory therapy, including the use of biologics. Aetiological factors for secondary pouchitis should be evaluated and managed accordingly. Crohn's disease of the pouch is usually treated with biologics and its stricturing and fistulising complications can be treated with endoscopy or surgery. The underlying cause of cuffitis determines treatment strategies. Endoscopic polypectomy is recommended for large, symptomatic inflammatory polyps and polyps in the cuff. The management principles of extraintestinal manifestations of inflammatory bowel disease in patients with pouches are similar to those in patients without pouches.
- Published
- 2022