Inflammatory, infectious, and ischemic disorders of the pelvic pouch

Pouchitis refers to a spectrum of inflammatory disorders affecting the ileal reservoir following restorative proctocolectomy and can be classified as idiopathic or secondary if a specific identifiable entity is identified. Pouchitis is a principal complication of the ileal pouch-anal anastomosis (IPAA) procedure and understanding the evaluation, diagnosis, and treatment of pouchitis is essential for the physician managing IPAA patients. Diagnosis and treatment of pouchitis is typically aided with multidisciplinary coordinated care leveraging specialized medical, pathological, and pharmacological expertise. While most mild and acute episodes of idiopathic pouchitis are easily treated, the gravity of the disease is clear – pouchitis significantly impairs the quality of life for IPAA patients and is a common cause of pouch failure.