Treatment of chronic and refractory pouchitis

Chronic and refractory pouchitis are the most challenging phenotypes of pouch inflammation, which represent the worst end of the disease spectrum of pouchitis. There are multiple factors are associated with the development and disease course of chronic and refractory pouchitis. Those factors include the use non-steroidal anti-inflammatory drugs, Clostridium difficile infection, cytomegalovirus infection, presence of concurrent immune-mediated disorders, and pouch ischemia. The identification of those factors helps direct proper therapy.