Incidence, prevalence, and risk factors for pouchitis

Pouchitis is a complication of restorative proctocolectomy and ileal pouch-anal anastomosis surgery in patients who undergo the procedure for the treatment of inflammatory bowel disease or familial adenomatous polyposis. Patients can present with increased stool frequency, urgency, fecal seepage, and abdominal cramps. The reported cumulative frequency rates of pouchitis 10 years after IPAA surgery range from 23% to 60% in IBD patients and 0% to 11% in FAP patients. Although the pathogenesis of pouchitis is unclear, several risk factors for pouchitis have been identified including extraintestinal manifestations of inflammatory bowel disease, autoimmune disorder(s), severity of disease, serologic markers (serum IgG4, autoantibodies to bacterial antigens, p-ANCA, and anti-CBir1 flagellin antibody), genetic markers (NOD2 mutation), smoking, and certain dietary factors. In this review, we will focus on the incidence, prevalence, and risk factors associated with pouchitis.