Evidence map›Paper›PMID 40050487›Full record

ArticleJournal of gastroenterology2025

Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan.

Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

17 authors.

Shintaro AkiyamaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. akiyama@md.tsukuba.ac.jp.ORCID 0000-0003-0727-7638
Ryohei HayashiDepartment of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan.
Takeshi TakasagoDepartment of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan.
Kurando KusunokiDepartment of Gastroenterological Surgery, Division of Inflammatory Bowel Disease Surgery, Hyogo Medical University, Nishinomiya, Japan.
Hiroki IkeuchiDepartment of Gastroenterological Surgery, Division of Inflammatory Bowel Disease Surgery, Hyogo Medical University, Nishinomiya, Japan.
Kento TakenakaDepartment of Gastroenterology and Hepatology, Institute of Science Tokyo, Bunkyo-Ku, Tokyo, Japan.
Kazuhiro WatanabeDepartment of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kazutaka KoganeiDepartment of Inflammatory Bowel Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Nobuhiro UenoDivision of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
Mikihiro FujiyaDivision of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
Naoki HosoeCenter for Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan.
Fumikazu KoyamaDepartment of Surgery, Nara Medical University, Kashihara, Japan.
Yasuhisa SakataDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Motohiro EsakiDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Ken TakeuchiDepartment of Gastroenterology, IBD Center, Tsujinaka Hospital Kashiwanoha, Chiba, Japan.
Makoto NaganumaDivision of Gastroenterology and Hepatology, Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Kiichiro TsuchiyaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. kii.gast@md.tsukuba.ac.jp.

Funding

Japan Society for the Promotion of Science 22K08026
6 · The paper itself

Abstract

backgroundEndoscopic phenotypes of pouchitis according to the Chicago Classification have been reported to be associated with poor pouch outcomes in ulcerative colitis (UC). Here, we aimed to assess the prevalence of endoscopic phenotypes and their predictability for pouch outcomes.

methodsThis retrospective multicenter study included UC patients aged 18 years or older who underwent total colectomy between January 2000 and March 2020. The primary endpoints were frequencies of endoscopic phenotypes of the Chicago Classification and their predictability for chronic pouchitis and pouch failure. Endoscopic findings were evaluated at the initial pouchoscopy and at 3 and 10 years after ileostomy takedown.

resultsA total of 392 eligible patients were identified. The frequencies of chronic pouchitis and pouch failure were 32% and 4.9%, respectively. Focal inflammation and inlet involvement at the initial postoperative pouchoscopy were significantly associated with subsequent risk of chronic pouchitis and pouch failure, respectively. Thirty percent of the patients with focal inflammation progressed to diffuse inflammation when chronic pouchitis developed. Multivariate analysis showed chronic pouchitis was significantly associated with diffuse inflammation and cuffitis observed throughout the clinical course. The proportion of pouch-related fistula was significantly lower in our cohort than in the US cohort (4.8% vs 19%, P < 0.001), and pouch-related fistula was an independent risk factor for pouch failure.

conclusionsWe demonstrated the predictability of the Chicago Classification for pouch outcomes, and a lower prevalence of pouch-related fistula, resulting in a lower pouch failure risk in our multicenter cohort.

Indexed as

Colitis, UlcerativePouchitisProctocolectomy, RestorativeAdultAgedChronic DiseaseColectomyColonic PouchesFemaleHumansJapanMaleMiddle AgedPostoperative ComplicationsPrevalenceRetrospective StudiesChicago ClassificationChronic pouchitisEndoscopic phenotypePouch failureUlcerative colitis

Identifiers

PMID40050487
PMCPMC12095421

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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.