Predictive factors for development of chronic pouchitis after ileal pouch-anal anastomosis in ulcerative colitis.

Abstract

BACKGROUND:

No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis.

METHODS:

A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression.

RESULTS:

231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥ 7.5-g cumulative steroid dose before colectomy and a ≥ 500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively).

CONCLUSION:

Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.

• Authors: Yoshiki Okita, Toshimitsu Araki, Koji Tanaka, Kiyoshi Hashimoto, Satoru Kondo, Mikio Kawamura, Yuki Koike, Kohei Otake, Hiroyuki Fujikawa, Mikihiro Inoue, Masaki Ohi, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
• Journal: Digestion (Digestion) Vol. 88 Issue 2 Pg. 101-9 ( 2013) ISSN: 1421-9867 [Electronic] Switzerland
• PMID: 23949485 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 S. Karger AG, Basel.

Topics

• Adolescent
• Adult
• Aged
• Child
• Chronic Disease
• Colitis, Ulcerative (surgery)
• Colonic Pouches (adverse effects)
• Female
• Humans
• Incidence
• Japan (epidemiology)
• Male
• Middle Aged
• Pouchitis (epidemiology, etiology)
• Retrospective Studies
• Young Adult