When “pouchitis” isn׳t pouchitis: Crohn׳s disease and surgical complications

Restorative proctocolectomy with ileal pouch-anal anastomosis is the definitive operation of choice for the surgical treatment of patients with ulcerative colitis that is refractory to medical therapy or with dysplasia. However, pouch dysfunction due to inflammatory and non-inflammatory diseases frequently affect patients after surgery and have a significant impact on quality of life. Accurate diagnosis is important to guide further therapy and it is essential to differentiate pouchitis from Crohn׳s disease or surgical complications. This article reviews diagnosis and management of Crohn׳s disease and surgical complications affecting the ileal pouch.