Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

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Gosselink MP, Schouten WR, van Lieshout LM, et al.: Eradication of pathogenic bacteria and restoration of normal pouch flora: comparison of metronidazole and ciprofloxacin in the treatment of pouchitis. Dis Colon Rectum 2004, 47:1519–1525. Ohge H, Furne JK, Springfield J, et al.: Association between fecal hydrogen sulfide production and pouchitis. Dis Colon Rectum 2005, 48:469–475. Falk A, Olsson C, Ahrne S, et al.: Ileal pelvic pouch microbiota from two former ulcerative colitis patients, analysed by DNA-based methods, were unstable over time and showed the presence of Clostridium perfringens. Scand J Gastroenterol 2007, 42:973–985. •• Komanduri S, Gillevet PM, Sikaroodi M, et al.: Dysbiosis in pouchitis: evidence of unique microfloral patterns in pouch inflammation. Clin Gastroenterol Hepatol 2007, 5:352–360. This article describes a comprehensive study of microbiota using 16sRNA-based molecular microbiology in pouchitis patients. McLaughlin SD, Walker AW, Churcher C, et al.: The bacteriology of pouchitis: a molecular phylogenetic analysis using 16 S rRNA gene cloning and sequencing [abstract]. Available at http://www.broadmedical.org/about/annual_meetings/2010/Abstract-McLaughlin.html. Accessed August 2010. Ottesen EA, Hong JW, Quake SR, et al.: Microfluidic digital PCR enables multigene analysis of individual environmental bacteria. Science 2006, 314:1464–1467. Liu WT, Zhu L: Environmental microbiology-on-a-chip and its future impacts. Trends Biotechnol 2005, 23:174–179. Marcy Y, Ouverney C, Bik EM, et al.: Dissecting biological “dark matter” with single-cell genetic analysis of rare and uncultivated TM7 microbes from the human mouth. Proc Natl Acad Sci U S A 2007, 104:11889–11894. •• Turroni S, Vitali B, Candela M, et al.: Antibiotics and probiotics in chronic pouchitis: a comparative proteomic approach. World J Gastroenterol 2010, 16:30–41. This article describes the first study to investigate the role of proteomics in chronic pouchitis. Kroesen AJ, Leistenschneider P, Lehmann K, et al.: Increased bacterial permeation in long-lasting ileoanal pouches. Inflamm Bowel Dis 2006, 12:736–744. DeSilva HJ, Jones M, Prince C, et al.: Lymphocyte and macrophage subpopulations in pelvic ileal reservoirs. Gut 1991, 32:1160–1165. Hirata I, Berrebi G, Austin LL, et al.: Immunohistological characterization of intraepithelial and lamina propria lymphocytes in control ileum and colon and inflammatory bowel disease. Dig Dis Sci 1986, 31:593–603. • Navaneethan U, Shen B: Secondary pouchitis: those with identifiable etiopathogenetic or triggering factors. Am J Gastroenterol 2010, 105:51–64. This article presents a comprehensive review of the various causes of secondary pouchitis. Casadesus D, Tani T, Wakai T, et al.: Possible role of human cytomegalovirus in pouchitis after proctocolectomy with ileal pouch-anal anastomosis in patients with ulcerative colitis. World J Gastroenterol 2007, 13:1085–1089. •• Shen B, Jiang ZD, Fazio VW, et al.: Clostridium difficile infection in patients with ileal pouch-anal anastomosis. Clin Gastroenterol Hepatol 2008, 6:782–788. This article describes a very important study showing that C. difficile infection not only can occur in patients without a colon, but also can be common. Shen B, Remzi FH, Nutter B, et al.: Association between Immune-associated disorders and adverse outcomes of Ileal pouch-anal anastomosis. Am J Gastroenterol 2009, 104:655–664. • Shen B, Plesec TP, Remer E, et al.: Asymmetric endoscopic inflammation of the ileal pouch: a sign of ischemic pouchitis? Inflamm Bowel Dis 2010, 16:836–846. This article provides a description of ischemic pouchitis as a new disease entity. Shen B, Bennett AE, Fazio VW, et al.: Collagenous pouchitis. Dig Liver Dis 2006, 38:704–709. Shen B, Fazio VW, Bennett AE, et al.: Effect of withdrawal of non-steroidal anti-inflammatory drug use in patients with the ileal pouch. Dig Dis Sci 2007, 52:3321–3328. Sandborn WJ: Pouchitis: risk factors, frequency, natural history, classification and public health perspective. In Trends in Inflammatory Bowel Disease 1996. Edited by McLeod RS, Martin F, Sutherland LR, et al. Lancaster, UK: Kluwer Academic Publishers; 1997:51–63. Shen L, Lian L, Goldblum JR, Remzi FH: Development of de novo celiac disease after restorative proctocolectomy and ileal pouch-anal anastomosis. Inflamm Bowel Dis 2009, 15:1131–1132. • Navaneethan U, Shen B: Pros and cons of antibiotic therapy for pouchitis. Expert Rev Gastroenterol Hepatol 2009, 3:547–359. This article provides a comprehensive review of risks and benefits of antibiotic use in pouchitis. Heuschen UA, Allemeyer EH, Hinz G, et al.: Diagnosing pouchitis: comparative validation of two scoring systems in routine follow-up. Dis Colon Rectum 2002, 45:776–786. Shen B, Pardi DS, Bennett AE, et al.: The efficacy and tolerability of AST-120 (spherical carbon adsorbent) in active pouchitis. Am J Gastroenterol 2009, 104:1468–1474. •• Pardi DS, D’Haens G, Shen B, et al.: Clinical guidelines for the management of pouchitis. Inflamm Bowel Dis 2009, 15:1424–1431. The authors present the only available guidelines on management of pouchitis. Shen B, Achkar J-P, Lashner BA, et al.: Endoscopic and histologic evaluations together with symptom assessment are required to diagnose pouchitis. Gastroenterology 2001, 121:261–267. Shen B, Achkar JP, Connor JT, et al.: Modified pouchitis disease activity index: a simplified approach to the diagnosis of pouchitis. Dis Colon Rectum 2003, 46:748–753. 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Int J Colorectal Dis 2006, 21:711–720. Lu H, Lian L, Navaneethan U, Shen B: Clinical utility of C-reactive protein in patients with ileal pouch anal anastomosis. Inflamm Bowel Dis 2010 (Epub ahead of print). Walkowiak J, Banasiewicz T, Krokowicz P, et al.: Fecal pyruvate kinase (M2-PK): a new predictor for inflammation and severity of pouchitis. Scand J Gastroenterol 2005, 40:1493–1494. Johnson MW, Maestranzi S, Duffy AM, et al.: Fecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. Eur J Gastroenterol Hepatol 2008, 20:174–179. Parsi M, Shen B, Achkar J, et al.: Fecal lactoferrin for diagnosis of symptomatic patients with ileal pouch-anal anastomosis. Gastroenterology 2004, 126:1280–1286. Lim M, Gonsalves S, Thekkinkattil D, et al.: The assessment of a rapid noninvasive immunochromatographic assay test for fecal lactoferrin in patients with suspected inflammation of the ileal pouch. Dis Colon Rectum 2008, 51:96–99. Melmed GY, Fleshner PR, Bardakcioglu O, et al.: Family history and serology predict Crohn’s disease after ileal pouch-anal anastomosis for ulcerative colitis. Dis Colon Rectum 2008, 51:100–108. Tang L, Boone J, Moore L, et al.: Clinical significance of stool ASCA in disorders of the ileal pouch [abstract]. Inflamm Bowel Dis 2008, 12: S2. Shen B: Campylobacter infection in patients with ileal pouches. Am J Gastroenterol 2010, 105:472–473. • McLaughlin SD, Clark SK, Shafi S, et al.: Fecal coliform testing to identify effective antibiotic therapies for patients with antibiotic-resistant pouchitis. Clin Gastroenterol Hepatol 2009, 7:545–548. This article describes the first study to report the use of fecal coliform testing for treating patients with antibiotic-resistant pouchitis. Seggerman RE, Chen MY, Waters GS, Ott DJ: Radiology of ileal pouch-anal anastomosis surgery. AJR Am J Roentgenol 2003, 180:999–1002. Shen B, Fazio VW, Remzi FH, et al.: Comprehensive evaluation of inflammatory and noninflammatory sequelae of ileal pouch-anal anastomoses. Am J Gastroenterol 2005, 100:93–101. Shepherd NA, Hulten L, Tytgat GN, et al.: Workshop: pouchitis. Int J Colorectal Dis 1989, 4:205–229. Sagar PM, Pemberton JH: Ileo-anal pouch function and dysfunction. Dig Dis 1997, 15:172–188. Madden MV, McIntyre AS, Nicholls RJ: Double-blind crossover trial of metronidazole versus placebo in chronic unremitting pouchitis. Dig Dis Sci 1994, 39:1193–1196. Shen B, Achkar JP, Lashner BA, et al.: A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. Inflamm Bowel Dis 2001, 7:301–305. Pepin J, Saheb N, Coulombe MA, et al.: Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile–associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 2005, 41:1254–1260. Isaacs KL, Sandler RS, Abreu M, et al.: Rifaximin for the treatment of active pouchitis: A randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis 2007, 13:1250–1255. Shen B, Remzi FH, Lopez AR, Queener E: Rifaximin for maintenance therapy in antibiotic-dependent pouchitis. BMC Gastroenterol 2008, 8:26. Shen B, Fazio V, Remzi F, et al.: Combined ciprofloxacin and tinidazole therapy in the treatment of chronic refractory pouchitis. Dis Col Rectum 2007, 50:498–508. • Ha CY, Bauer JJ, Lazarev M, et al.: Early institution of tinidazole may prevent pouchitis following ileal-pouch anal anastomosis (IPAA) surgery in ulcerative colitis (UC) patients [abstract]. Gastroenterology 2010, 138:S69. The authors describe a randomized, controlled trial of tinidazole in preventing pouchitis after IPAA surgery. Gionchetti P, Rizzello F, Helwig U, et al.: Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. 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