Disease and Treatment Patterns Among Patients With Pouch-related Conditions in a Cohort of Large Tertiary Care Inflammatory Bowel Disease Centers in the United States

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.


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.

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