Pouchitis after IPAA in ulcerative colitis

Q) Which of the following is Not a risk factor for pouchitis post IPAA in ULcerative colitis

A) Smoking
B ) NSAIDs use post op
C) Elderly patients
D) UC with extra intestinal manifestation


Ans a

Pouchitis is the complication of Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative colitis. The incidence of pochitis for the same proedure for familial Adenomatous polyposis is less than 10% but for ulcerative colitis can go as high as 50%.

Risk factors for development of pouchitis are

  1. Previous extra intestinal manifestations of IBD especially arthritis
  2. ANCA positive cases of UC
  3. NOD2insC  positive patients
  4. Smoking prevents the development of puchitis after IPAA in ulcerative colitis.

5. Other reported factors that may associate with pouchitis include extent of UC, thrombocytosis,and PPI use with  NSAId

Ref - https://onlinelibrary.wiley.com/doi/full/10.1111/den.12744