Rabbenou Wendy, Chang Shannon
Division of Gastroenterology and Hepatology, New York University Langone Medical Center, New York, NY, USA.
Division of Gastroenterology and Hepatology, New York University Langone Medical Center, 305 E 33rd Street, New York, NY 10016, USA.
Therap Adv Gastroenterol. 2021 Jun 27;14:17562848211023376. doi: 10.1177/17562848211023376. eCollection 2021.
Pouchitis is the most common complication in patients who have undergone restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Up to 81% of IPAA patients experience pouchitis, with 40% of patients presenting within the first year of surgery. Common risk factors include genetic mutations, extensive colitis, rheumatologic disorders, and primary sclerosing cholangitis. Currently, there are no medications with approved indications for pouchitis. As such, the conventional treatment of pouchitis is entirely off-label. This paper is intended to be a practical and up-to-date review of available therapies used for the management of pouchitis. The mainstay of treatment for acute pouchitis remains antibiotics, but newer therapeutics have also shown promise in the treatment of chronic pouchitis. Common lifestyle considerations that may play a role in pouchitis are also reviewed.
The ileal pouch-anal anastomosis ("pouch") is the most common way patients who require surgery to remove their colon are able to avoid a permanent ileostomy ("ostomy"). This pouch, created from the small intestines, serves as a reservoir to hold stool. The most common complication after pouch surgery is pouchitis. Pouchitis symptoms include more frequent bowel movements, urgency to defecate, blood in the stool, incontinence, and abdominal pain. This paper is intended to be a practical review of available therapies including medications and lifestyle changes that can be considered for the management of acute pouchitis, chronic pouchitis, and cuffitis.
袋炎是接受回肠储袋肛管吻合术（IPAA）的直肠结肠切除术后患者最常见的并发症。高达81%的IPAA患者会发生袋炎，其中40%的患者在术后第一年内出现症状。常见的危险因素包括基因突变、广泛性结肠炎、风湿性疾病和原发性硬化性胆管炎。目前，尚无获批用于治疗袋炎的药物。因此，袋炎的传统治疗完全属于超说明书用药。本文旨在对用于治疗袋炎的现有疗法进行实用且最新的综述。急性袋炎的主要治疗方法仍然是使用抗生素，但新的治疗方法在慢性袋炎的治疗中也显示出了前景。本文还综述了可能在袋炎中起作用的常见生活方式因素。
回肠储袋肛管吻合术（“储袋”）是需要手术切除结肠的患者避免永久性回肠造口术（“造口”）的最常见方法。这个由小肠制成的储袋用作储存粪便的容器。储袋手术后最常见的并发症是袋炎。袋炎的症状包括排便更频繁、排便急迫感、便血、大便失禁和腹痛。本文旨在对可用于治疗急性袋炎、慢性袋炎和袖口炎的现有疗法进行实用综述，包括药物治疗和生活方式改变。
