Crohns Colitis 360. 2020 Jul;2(3):otaa039. doi: 10.1093/crocol/otaa039. Epub 2020 Jul 24.

Edward L Barnes ^1 2 3, Laura Raffals ⁴, Millie D Long ^1 2 3, Gaurav Syal ⁵, Maia Kayal ⁶, Ashwin Ananthakrishnan ⁷, Benjamin Cohen ⁶, Joel Pekow ⁸, Parakkal Deepak ⁹, Jean-Frederic Colombel ⁶, Hans H Herfarth ^1 2 3, Robert S Sandler ^1 2

Author information

• ¹Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
• ²Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina, USA.
• ³Multidisciplinary Inflammatory Bowel Diseases Center, University of North Carolina, Chapel Hill, North Carolina, USA.
• ⁴Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
• ⁵Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
• ⁶The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• ⁷Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
• ⁸Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, Illinois, USA.
• ⁹Washington University Inflammatory Bowel Diseases Center, St. Louis, Missouri, USA.

Abstract

Background: Gaps exist in our understanding of the clinical course of pouch-related disorders.

Methods: We evaluated baseline disease activity and longitudinal treatment patterns among patients with inflammatory conditions of the pouch.

Results: Among 468 patients with an ileal pouch-anal anastomosis (IPAA), 94 (20%) had acute pouchitis, 96 (21%) had chronic pouchitis, and 192 (41%) had Crohn disease of the pouch. Following an IPAA, 38% of patients were treated with a biologic and 11% underwent inflammatory bowel disease- or bowel-related surgery.

Conclusions: Treatment patterns after IPAA indicate that pouch-related disorders have a significant impact on individual patients and the healthcare system.