What Is Pouchitis?
Pouchitis is inflammation of the internal pouch—a surgically created reservoir formed from the small intestine during an ileal pouch-anal anastomosis (IPAA), commonly referred to as J-pouch surgery. This procedure is typically performed for individuals with ulcerative colitis who have had their colon and rectum removed.
Instead of relying on a permanent external ostomy bag, surgeons create a pouch from the end of the small intestine and attach it directly to the anus. This internal pouch allows for the natural storage and passage of stool, helping patients maintain normal bowel function and continence.
When inflammation occurs within this pouch, it can cause symptoms such as urgency, diarrhea, abdominal cramping, and fatigue. If these symptoms persist despite treatment or repeatedly recur, the condition is known as chronic pouchitis.
What Causes It?
The exact cause of pouchitis isn’t fully understood, but several factors may contribute, including:
- An overactive immune response
- An imbalance in gut bacteria (dysbiosis)
- Previous inflammation related to ulcerative colitis
- Frequent or prolonged use of certain medications, such as NSAIDs (ibuprofen, naproxen)
- Underlying inflammatory bowel disease (IBD)
- Infections or bacterial overgrowth within the pouch
- Reduced blood flow (ischemia) to pouch tissue
- Dietary triggers or food sensitivities
Symptoms of Chronic Pouchitis
- Urgent bowel movements
- Less formed stool
- Abdominal cramps and/or pain
- Nighttime leakage
- Incontinence
- Fatigue
- Fever or blood in stool (in more severe cases)
How It’s Diagnosed
- Medical history
- Stool and blood tests
- Pouchoscopy (to view inflammation inside the pouch)
Living With It
New Research, New Hope
If you or a loved one is living with chronic pouchitis following J-pouch surgery for ulcerative colitis, a new clinical trial may offer a potential treatment option.