ArticleAlimentary pharmacology & therapeutics2019
Endoscopic activity in asymptomatic patients with an ileal pouch is associated with an increased risk of pouchitis.
Article in Alimentary pharmacology & therapeutics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Is Ustekinumab Effective in Refractory Crohn's Disease of the Pouch and Chronic Pouchitis? A Systematic Review.Digestive diseases and sciences · 2022Pooled it
- IBD 2024: Charting a New Course in IBD Proceedings of the Takeda Symposium 22-23 November 2024 W Hotel, Brisbane, Queensland, Australia.Journal of gastroenterology and hepatology · 2025Article
- Managing Pouchitis: Where do Antibiotics End, and Advanced Therapies Begin?Current gastroenterology reports · 2025Review
- A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease.Crohn's & colitis 360 · 2024Article
- Preoperative Use of Multiple Advanced Therapies Is Not Associated With Endoscopic Inflammatory Pouch Diseases.Inflammatory bowel diseases · 2024Article
- Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study.Intestinal research · 2024Article
- Histologic Predictors of Clinical Outcomes and Healthcare Utilization in Patients With Ileal Pouch-Anal Anastomosis.Inflammatory bowel diseases · 2023Article
- Outcomes of Ileoanal Pouch Anastomosis in Pediatric Ulcerative Colitis Are Worse in the Modern Era: A Time Trend Analysis Outcomes Following Ileal Pouch-Anal Anastomosis in Pediatric Ulcerative Colitis.Inflammatory bowel diseases · 2022Article
- Endoscopic Phenotype of the J Pouch in Patients With Inflammatory Bowel Disease: A New Classification for Pouch Outcomes.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Article
- Ileal Pouchitis With Endoscopic Pictures.Cureus · 2021Article
- Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment.Intestinal research · 2021Review
- Pouchitis: Clinical Features, Diagnosis, and Treatment.International journal of general medicine · 2021Review
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Authors and funding
14 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe significance of endoscopic activity in asymptomatic ulcerative colitis (UC) patients with an ileal pouch is unknown.
aimTo investigate the association of endoscopic pouch activity in asymptomatic patients with the subsequent development of pouchitis.
methodsWe analyzed a retrospective cohort of patients with UC or IBD-unspecified who underwent a total proctocolectomy with ileal pouch anal anastomosis (IPAA). Asymptomatic patients with a Pouchitis Disease Activity Index (PDAI) symptom sub-score of zero who underwent an index surveillance pouchoscopy were included. Endoscopic pouch body activity was graded as 0: normal, 1: mucosal inflammation, or 2: mucosal breaks (ulcers and/or erosions). The primary outcome was primary acute idiopathic pouchitis defined as PDAI score ≥ 7 with symptoms lasting less than four weeks and responsive to standard antibiotics, not otherwise meeting criteria for secondary pouchitis. The secondary outcome was chronic idiopathic pouchitis defined as PDAI score ≥ 7 with symptoms lasting greater than four weeks despite standard antibiotics. Predictors of pouchitis were analyzed using Kaplan-Meier and Cox regression methods with hazard ratios (HR) and 95% confidence intervals (CI) reported.
results143 asymptomatic pouch patients were included. Index endoscopic pouch body activity was 0 in 86 (60.1%) patients, 1 in 26 (18.2%) and 2 in 31 (21.7%). The median length of follow-up after index surveillance pouchoscopy was 3.03 [IQR 1.24-4.60] years. Primary acute idiopathic pouchitis occurred in 44 (31%) patients and chronic idiopathic pouchitis in 12 (8.4%). Grade 2 endoscopic pouch activity was associated with the development of acute pouchitis (HR 2.39, 95% CI 1.23-4.67), although not chronic pouchitis (HR 1.76, 95% CI 0.53-5.87). Histologic inflammation in endoscopically normal pouch mucosa was not associated with acute or chronic pouchitis.
conclusionsMucosal breaks are present in nearly a quarter of asymptomatic patients with IPAA and are associated with an increased risk of acute pouchitis.
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