What is Pouchitis?

Pouchitis is an inflammation of the ileal pouch, an internal reservoir created in those who have undergone surgical removal of part of the large intestine as a treatment for ulcerative colitis (UC). This type of surgery, known as a restorative proctocolectomy, creates a new permanent system for passing stool. In some cases, the ileal pouch can become inflamed, a condition known as pouchitis.

Pouchitis can cause a variety of symptoms including abdominal pain and cramping, frequent loose stools or diarrhea, rectal bleeding, and general fatigue. Some people may also experience nausea, urgency to have a bowel movement, or a feeling of incomplete emptying after a bowel movement.

Risk Factors & Causes

The exact cause of pouchitis is not known. Possible contributing factors may include:

  • Bacteria that originate from the rectum
  • Inadequate cleaning of the ileal pouch
  • Constant irritation of the pouch due to constant diarrhea.
  • The use of medications such as antibiotics and steroids

Certain risk factors can also increase your chance of developing pouchitis, including:

  • Having a family history of pouchitis
  • Smoking
  • Having a history of Crohn's disease
  • Being between 40–60 years old

Diagnosis & Treatment

Your doctor will typically perform a physical exam and ask you about your symptoms. Your doctor may also order a series of tests and procedures to diagnose your condition. This may include blood tests, imaging scans, fecal tests, and a pouchoscopy.

Treatment for pouchitis may include antibiotics, antidiarrheal medications, and immunosuppressive medications. In some cases, surgery may be necessary if the pouch is not functioning properly. Diet can also play a role in the management of pouchitis. Some people may find that certain foods can aggravate their symptoms and others may find that certain foods help reduce their symptoms.

Prevention & Outlook

It is important to maintain good hygiene and remove any debris or bacteria from the ileal pouch. Keeping the pouch clean, as well as avoiding certain medications, may help reduce your chances of developing pouchitis.

The outlook for those with pouchitis varies from person to person. Many people find that with proper treatment and lifestyle modifications, they are able to manage their symptoms and live a normal life.