"A similar condition, diversion pouchitis, manifesting after formation of continent pouches (e.g. following ileal pouch-anal anastomosis) has a very similar presentation and likely exists due to the same pathophysiology. It should be noted this entity is distinct from an acute infective pouchitis."
"The treatment of choice is surgical reanastomosis 2,3. In patients who are not surgical candidates, medical therapies which have shown benefit include SCFA enemas, immunosuppression (e.g. topical mesalazine, systemic glucocorticoids), and faecal microbiota transplantation 2,3,7,8. Empiric antibiotics may also be used, especially in cases of pouchitis which may initially be thought to be infective and thus antibiotic-responsive, although this is not the case in true diversion pouchitis which typically does not respond to antibiotics 8."
Expected headings
"Fluoroscopy"
"Complications"
"Although the pathogenesis is not fully elucidated, one prevailing hypothesis proposes that diversion colitis and pouchitis are most likely caused a deficiency of luminal short-chain fatty acids (SCFAs) and other normal gut-produced nutrients 3,5. SCFAs, among other nutrients, are the products of carbohydrate metabolism by normal anaerobic intestinal flora and have multiple functions within the bowel, including being an energy source for colonocytes, playing a role in mucosal blood flow, and being important for normal colonic motility 3,5."
"The treatment of choice is surgical reanastomosis 2,3. In patients who are not surgical candidates, medical therapies which have shown benefit include SCFA enemas, immunosuppression (e.g. topical mesalazine, systemic glucocorticoids), and faecal microbiota transplantation 2,3,7,8. Empiric antibiotics may also be used, especially in cases of pouchitis which may initially be thought to be infective and thus antibiotic-responsive, although this is not the case in true diversion pouchitis which typically does not respond to antibiotics 8."