Pouchitis can appear at the most inopportune times, and often when you least expect it. Fortunately, the frequency of pouchitis is relatively low in most patients, and when it does occur it is most often easily treatable. The true incidence of pouchitis is difficult to determine due to varying criteria for diagnosis and variable degrees of severity. (1)
The exact cause of pouchitis is still unknown, but the change in bowel pattern due to ileal surgery is expected to play the biggest role. Since sections of bowel that once acted as a pathway for waste are converted into waste storage space after surgery, the body's immune response can play a role in causing the site to become inflamed.
Treatments can vary, but most often your doctor will prescribe an antibiotic (most commonly ciprofloxacin and/or metronidazole) in order to try and reduce the inflammation and calm the effects of the condition. Occasionally, depending on the severity, your doctor may want to perform an endoscopy and do a biopsy on the affected site before making his diagnosis and prescribing an antibiotic.
As with any intake of a high-powered antibiotic, it's important to counteract the effects on the good bacteria in your body by incorporating a probiotic into your diet. Though probiotics can be taken orally in pill form, there are several probiotic-rich yogurts in your local grocery store that can help start to bring back the good bacteria in your body. Make sure to space out the antibiotic and probiotic.
While scientific evidence has yet to confirm this, there are many who believe that excluding complex carbohydrates, diary products and foods with high starch content can help relieve the effects of pouchitis as well. Though no hard evidence exists currently, changes in diets can certainly affect different people in different ways. Being mindful of the food you consume and the way it affects you individually may help you better understand your body and prevent blockages, feelings of bloating and possibly instances of pouchitis in the future.
According to estimates, roughly 10% of patients may find themselves dealing with chronic pouchitis. When chronic pouchitis is diagnosed, your doctor may want to try a few different treatments in order to counteract the affects of chronic inflammation to the ileal pouch.
If you start to notice abnormal cramps, discomfort, bloody or discolored waste, you may be experiencing the early stages of pouchitis. Contact your doctor to learn about treatment options. Don't wait!
(1)Barnett Continent Intestinal Reservoir. Reprinted from Diseases of the Colon & Rectum. Vol. 38 No. 6 1995.
(2) Pardi DS, D'Haens G, Shen B, et al. Clinical guidelines for the management of pouchitis. Inflamm Bowel Dis2009;9:1424–31.
(3) Haveran LA, Sehgal R, Poritz LS, et al. Infliximab and/or azathioprine in the treatment of Crohn's disease-like complications after IPAA. Dis Colon Rectum 2011;54:15–20.