Lancet Gastroenterol Hepatol. 2021 Oct;6(10):826-849.doi: 10.1016/S2468-1253(21)00101-1. Epub 2021 Aug 18.

Bo Shen ¹, Gursimran S Kochhar ², Revital Kariv ³, Xiuli Liu ⁴, Udayakumar Navaneethan ⁵, David T Rubin ⁶, Raymond K Cross ⁷, Akira Sugita ⁸, André D'Hoore ⁹, Jason Schairer ¹⁰, Francis A Farraye ¹¹, Ravi P Kiran ¹², Philip Fleshner ¹³, Joel Rosh ¹⁴, Samir A Shah ¹⁵, Shannon Chang ¹⁶, Ellen Scherl ¹⁷, Darrell S Pardi ¹⁸, David A Schwartz ¹⁹, Paulo G Kotze ²⁰, David H Bruining ¹⁸, Sunanda V Kane ¹⁸, Jessica Philpott ²¹, Bincy Abraham ²², Jonathan Segal ²³, Rocio Sedano ²⁴, Maia Kayal ²⁵, Stuart Bentley-Hibbert ²⁶, Dino Tarabar ²⁷, Sandra El-Hachem ², Priya Sehgal ²⁸, James T McCormick ²⁹, Joseph A Picoraro ³⁰, Mark S Silverberg ³¹, Charles N Bernstein ³², William J Sandborn ³³, Séverine Vermeire ³⁴

Author information

¹Center for Interventional Inflammatory Bowel Disease, Columbia University Irving Medical Center-New-York Presbyterian Hospital, NY, USA. Electronic address: bs3270@cumc.columbia.edu.

²Division of Gastroenterology, Hepatology, and Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.

³Department of Gastroenterology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

⁴Department of Pathology and Immunology, Washington University, MO, USA.

⁵IBD Center and IBD Interventional Unit, Center for Interventional Endoscopy, Orlando Health, Orlando, FL, USA.

⁶Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA.

⁷Inflammatory Bowel Disease Program, University of Maryland School of Medicine, Baltimore, MD, USA.

⁸Department of Clinical Research and Department of Inflammatory Bowel Disease, Yokohama Municipal Citizens Hospital Yokohama, Japan.

⁹Department of Abdominal Surgery, University Hospital Leuven, Belgium.

¹⁰Department of Gastroenterology, Henry Ford Health System, Detroit, MI, USA.

¹¹Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.

¹²Division of Colorectal Surgery, Columbia University Irving Medical Center-New-York Presbyterian Hospital, NY, USA.

¹³Division of Colorectal Surgery, University of California-Cedars Sinai Medical Center, Los Angeles, CA, USA.

¹⁴Department of Pediatric Gastroenterology, Goryeb Children's Hospital-Atlantic Health, Morristown, NJ, USA.

¹⁵Alpert Medical School of Brown University and Miriam Hospital, Gastroenterology Associates, Providence, RI, USA.

¹⁶Division of Gastroenterology, New York University Langone Health, New York, NY, USA.

¹⁷New York Presbyterian Hospital, Jill Roberts Center for IBD, Weill Cornell Medicine, Gastroenterology and Hepatology, New York, NY, USA.

¹⁸Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

¹⁹Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN, USA.

²⁰IBD Outpatients Clinic, Catholic University of Paraná, Curitiba, Brazil.

²¹Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH, USA.

²²Houston Methodist and Weill Cornell Medical College, Houston, TX, USA.

²³Department of Gastroenterology and Hepatology, Hillingdon Hospital, Uxbridge, UK.

²⁴Department of Medicine, Division of Gastroenterology, Western University, London, ON, Canada.

²⁵Department of Gastroenterology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.

²⁶Department of Radiology, Columbia University Irving Medical Center-New-York Presbyterian Hospital, NY, USA.

²⁷IBD Clinical Center, University Hospital Center Dr Dragiša Mišovic, Belgrade, Serbia.

²⁸Division of Digestive and Liver Diseases, Columbia University Irving Medical Center-New-York Presbyterian Hospital, NY, USA.

²⁹Division of Colon and Rectal Surgery, Allegheny Health Network, Pittsburgh, PA, USA.

³⁰Department of Pediatrics, Columbia University Irving Medical Center-Morgan Stanley Children's Hospital, New York, NY, USA.

³¹Mount Sinai Hospital Inflammatory Bowel Disease Centre, Toronto, ON, Canada.

³²Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.

³³Department of Gastroenterology, University of California San Diego, San Diego, CA, USA.

³⁴Department of Gastroenterology, University hospitals Leuven, Leuven, Belgium.

Abstract

Restorative proctocolectomy with ileal pouch-anal anastomosis is an option for most patients with ulcerative colitis or familial adenomatous polyposis who require colectomy. Although the construction of an ileal pouch substantially improves patients' health-related quality of life, the surgery is, directly or indirectly, associated with various structural, inflammatory, and functional adverse sequelae. Furthermore, the surgical procedure does not completely abolish the risk for neoplasia. Patients with ileal pouches often present with extraintestinal, systemic inflammatory conditions. The International Ileal Pouch Consortium was established to create this consensus document on the diagnosis and classification of ileal pouch disorders using available evidence and the panellists' expertise. In a given individual, the condition of the pouch can change over time. Therefore, close monitoring of the activity and progression of the disease is essential to make accurate modifications in the diagnosis and classification in a timely manner.