[Therapy of pouchitis after J-pouch ileoanal anastomosis (case report)]

Abstract

The ileal pouch-anal operation is the best procedure because it liberates the patient from ulcerative colitis i.e. from diseased mucosa of the large intestine. The ileal pouch forms a new reservoir for the storage of feces. Symptomatic pouch inflammation (pouchitis) appeared in 7-40% of the patients. The authors describe a 19-year-old young man with pouchitis after ileoanal J-pouch anastomosis. He had symptoms of "rectal" cramping, diarrhea, fever, anorexia and extraintestinal manifestations such as arthritis and uveitis, without hematochezia and erythema nodosum. Three times he was treated for pouchitis at the Ward of Surgery. Diagnosis was made on clinical symptoms, endoscopic examination, response to the therapy and exclusion of infectious enteritis. After receiving metronidazole, loperamide, sulfasalazine and infusions, all symptoms disappeared.