ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022
Endoscopic Phenotype of the J Pouch in Patients With Inflammatory Bowel Disease: A New Classification for Pouch Outcomes.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders.Gastroenterology · 2024Guideline
- Review
- Assessing the Value of Histology and Anatomic Segment Evaluation Among Patients Undergoing Pouchoscopy.Inflammatory bowel diseases · 2025Article
- Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan.Journal of gastroenterology · 2025Article
- Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis.Gut and liver · 2025Article
- Review
- Tofacitinib for the treatment of chronic pouchitis: A pilot study.United European gastroenterology journal · 2025Article
- Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease.Inflammatory bowel diseases · 2025Article
- Navigating Chronic Pouchitis: Pathogenesis, Diagnosis, and Management.Gastroenterology & hepatology · 2025Article
- Clinical and histological impact of diffuse inflammation at pouchoscopy.International journal of colorectal disease · 2024Article
- Extensive Colitis and Smoking Are Associated With Postoperative Complications Within 30 Days of Ileal Pouch-Anal Anastomosis.Inflammatory bowel diseases · 2024Article
- Pouchitis: pathophysiology and management.Nature reviews. Gastroenterology & hepatology · 2024Review
- 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
- The aetiology of pouchitis in patients with inflammatory bowel disease.Therapeutic advances in gastroenterology · 2024Review
- Acute Severe Ulcerative Colitis Is Associated With an Increased Risk of Acute Pouchitis.Inflammatory bowel diseases · 2023Article
- Treatment of Chronic Inflammatory Pouch Conditions With Tofacitinib: A Case Series From 2 Tertiary IBD Centers in the United States.Inflammatory bowel diseases · 2023Article
- Development of the Endoscopic Pouch Score for Assessment of Inflammatory Conditions of the Pouch.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Risk Factors and Quality of Life in Patients with Diffuse Pouchitis After Ileal Pouch Anal Anastomosis According to the Chicago Classification for J Pouch: a Retrospective Multicenter Cohort Study in China.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
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19 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsPouchitis is a common complication of ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis who have undergone colectomy. Pouchitis has been considered a single entity despite a broad array of clinical and endoscopic patterns. We developed a novel classification system based on the pattern of inflammation observed in pouches and evaluated the contributing factors and prognosis of each phenotype.
methodsWe identified 426 patients (384 with ulcerative colitis) treated with proctocolectomy and IPAA who subsequently underwent pouchoscopies at the University of Chicago between June 1997 and December 2019. We retrospectively reviewed 1359 pouchoscopies and classified them into 7 main pouch phenotypes: (1) normal, (2) afferent limb involvement, (3) inlet involvement, (4) diffuse, (5) focal inflammation of the pouch body, (6) cuffitis, and (7) pouch with fistulas noted 6 months after ileostomy takedown. Logistic regression analysis was used to assess factors contributing to each phenotype. Pouch survival was estimated by the log-rank test and the Cox proportional hazards model.
resultsSignificant contributing factors for afferent limb involvement were a body mass index of 25 or higher and hand-sewn anastomosis, for inlet involvement the significant contributing factor was male sex; for diffuse inflammation the significant contributing factors were extensive colitis and preoperative use of anti-tumor necrosis factor drugs, for cuffitis the significant contributing factors were stapled anastomosis and preoperative Clostridioides difficile infection. Inlet stenosis, diffuse inflammation, and cuffitis significantly increased the risk of pouch excision. Diffuse inflammation was associated independently with pouch excision (hazard ratio, 2.69; 95% CI, 1.34-5.41; P = .005).
conclusionsWe describe 7 unique IPAA phenotypes with different contributing factors and outcomes, and propose a new classification system for pouch management and future interventional studies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.