Gionchetti Paolo, Calabrese Carlo, Lauri Adriano, Rizzello Fernando
a Department of Medical and Surgical Sciences (DIMEC), University of Bologna-Italy, Bologna, Italy.
Expert Rev Gastroenterol Hepatol. 2015;9(9):1175-81. doi: 10.1586/17474124.2015.1072046. Epub 2015 Jul 25.
Pouchitis is the most frequent long-term complication of pouch surgery for ulcerative colitis. There is consistent evidence on the implication of bacterial flora in the pathogenesis of pouchitis, and there is evidence for a therapeutic role of antibiotics and probiotics in therapy of this disease. Antibiotics, particularly ciprofloxacin and metronidazole, are the mainstay of treatment for acute pouchitis. In chronic refractory pouchitis, after having excluded other diagnoses (infections, Crohn's disease of the pouch, ischemia and irritable pouch), antibiotic combination therapy is the treatment of choice. The highly concentrated probiotic mixture VSL#3 has been shown to be effective in prevention of pouchitis onset and in maintaining antibiotic-induced remission.
袋炎是溃疡性结肠炎行袋状手术最常见的长期并发症。有一致的证据表明肠道菌群在袋炎发病机制中起作用，并且有证据显示抗生素和益生菌在该疾病治疗中具有治疗作用。抗生素，尤其是环丙沙星和甲硝唑，是急性袋炎治疗的主要手段。对于慢性难治性袋炎，在排除其他诊断（感染、袋状克罗恩病、缺血和易激袋）后，抗生素联合治疗是首选治疗方法。高浓度益生菌混合物VSL#3已被证明在预防袋炎发作和维持抗生素诱导的缓解方面有效。
