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Session: ePoster Monitor 5-IBD 3

eP730 - The Clinical Course and Optimal Treatment for Pouch Disorders with Ulcerative Colitis

Tuesday, June 4, 2024
7:48 AM – 7:53 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Akira Sugita, MD. PhD

    Clinical Adviser
    Dep. of IBD, Yokohama Municipal Citizen's Hospital
    The Research Group of Intractable Inflammatory Bowel Disease
    Yokohama, Kanagawa, Japan

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • KK

    Kazutaka Koganei, MD. PhD

    Director
    Dep.of IBD. Yokohama Municipal Citizen's Hospital
    Yokohama, Kanagawa, Japan

    Disclosure information not submitted.

  • KT

    Kenji Tatsumi, MD. PhD

    Dr.
    Dep. of IBD, Yokohama Municipal Citizen's Hospital
    Yokohama, Kanagawa, Japan

    Disclosure information not submitted.

  • HK

    Hirosuke Kuroki, MD.

    Dr.
    Dep. of IBD, Yokohama Municipal Citizen's Hospital
    Yokohama, Kanagawa, Japan

    Disclosure information not submitted.

  • NO

    Nao Obara, MD.

    Dr.
    Dep. of IBD, Yokohama Municipal Citizen's Hospital
    Yokohama, Kanagawa, Japan

    Disclosure information not submitted.

  • HK

    Hideaki Kimura, MD. PhD

    Director
    IBD Center, Yokohama City University Medical Center
    Yokohama, Kanagawa, Japan

    Disclosure information not submitted.

Purpose/Background: Pouch disorders disturb patients’ QOL after restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) in ulcerative colitis (UC). However, the actual condition of pouch disorders is not precisely described.This study was conducted to examine pouch disorders including the clinical course and current treatment.Methods/Interventions: Thirteen hundred and sixty UC pouch patients (hand sewn IPAA 201, stapled IPAA with preservation of cuff and ATZ 1159) in our institution were included. Pouch disorders included prepouch ileitis (ulcer, erosion irrespective of clinical symptoms), chronic pouchitis (antibiotic dependent, refractory for ≧4 weeks antibiotic, relapse≧3 times/year), cuffitis, pouch neoplasia, and suspicious diagnosis of pouch Crohn’s disease. The clinical course and current treatment were analyzed retrospectively.Results/Outcomes: Prepouch ileitis was detected in 1.3% (17 cases), one of them underwent ileal resection for the stricture. Chronic pouchitis was diagnosed in 3.2% (44 cases with antibiotic treatment), 10 cases of them were treated with vedolizumab, one with ileostomy, and 2 with pouch resection. Cuffitis was detected in 0.4% (5 cases), one of them was treated with anti TNFα antibody drug, and 3 with pouch excision. Pouch neoplasia was detected in 0.7% (10 cases: pouch body 3. cuff and ATZ 6, fistula tract from the anastomosis 1), all of them underwent pouch excision. Suspicious Crohn’s disease was found in 0.4% (6 cases), 3 of them were treated with anti TNFα antibody drug, and 2 with surgery.Conclusion/

Discussion: Pouch disorders with UC were frequently detected by regular pouch endoscopy and treated with biologics or surgery including pouch excision. The regular pouch endoscopic examination is necessary for the precise diagnosis and optimal treatment for pouch disorders.