Evidence map›Paper›PMID 39826061›Full record

ReviewDigestive diseases and sciences2025

Medical, Endoscopic, and Surgical Treatments for Rectal Cuffitis in IBD Patients with an Ileal Pouch-Anal Anastomosis: A Narrative Review.

Joseph Carter Powers, Emma Dester, Mary Schleicher, Benjamin Cohen, Bret Lashner, Andrei I Ivanov, Tracy Hull, Katherine Falloon, Taha Qazi

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joseph Carter PowersCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Emma DesterCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Mary SchleicherCleveland Clinic Floyd D. Loop Alumni Library, Cleveland, OH, USA.
Benjamin CohenDepartment of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Bret LashnerDepartment of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Andrei I IvanovDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH, USA.
Tracy HullDepartment of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Katherine FalloonDepartment of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Taha QaziDepartment of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. qazit@ccf.org.

Funding

Crohn's and Colitis Foundation 1155801
6 · The paper itself

Abstract

backgroundUlcerative colitis patients who undergo ileal pouch-anal anastomosis (IPAA) without mucosectomy may develop inflammation of the rectal cuff (cuffitis). Treatment of cuffitis typically includes mesalamine suppositories or corticosteroids, but refractory cuffitis may necessitate advanced therapies or procedural interventions. This review aims to summarize the existing literature regarding treatments options for cuffitis.

methodsA broad search strategy was created by a medical librarian to capture cuffitis in IPAA patients. A total of 1877 citations were identified, and 957 studies remained after removal of 920 duplicates. Two reviewers screened all 957 abstracts and 294 full-text articles to determine if they were eligible for inclusion in this review.

resultsTwenty-three studies met the inclusion criteria. Medical interventions were investigated in 16 studies with mesalamine and corticosteroid regimens being the most common, followed by ustekinumab, vedolizumab, hyperbaric oxygen, tofacitinib, risankizumab, and infliximab. Studies investigating mesalamine and corticosteroid use generally had larger samples (ranging 4-120 patients) and showed symptomatic improvement in 52-100% of patients and decreases of 1.14-1.8 points in endoscopic disease activity indices. In contrast, advanced therapy studies had small samples (ranging 1-21 patients) and variable responses. Seven studies explored endoscopic and surgical approaches including secondary mucosectomy, cuff resection, needle-knife therapy, and balloon dilation for concomitant outlet strictures. These techniques generally resulted in symptomatic resolution but were limited by small samples (ranging 3-40 patients).

conclusionStudies evaluating therapies used to treat cuffitis suggest benefit from conventional mesalamine or corticosteroid-based therapies, whereas data regarding advanced therapies and interventional procedures are inconsistent given small sample sizes.

Indexed as

Colitis, UlcerativeColonic PouchesProctocolectomy, RestorativeAdrenal Cortex HormonesHumansMesalamineAdrenal Cortex HormonesMesalamineCuffitisIleal pouch-anal anastomosisInflammatory bowel diseaseTreatmentUlcerative colitis

Identifiers

PMID39826061
PMCPMC11919978

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Registered trials

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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.