Extraintestinal Manifestations and Family History of Inflammatory Bowel Disease Increase the Risk of Pouchitis in a State-Level Epidemiology Study.

Autor:	Barnes EL; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.; Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina, USA., Dunn MS; Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA., Ashburn J; Division of Colon and Rectal Surgery, Atrium Health at Wake Forest Baptist, Winston-Salem, North Carolina, USA., Barto A; Division of Gastroenterology and Hepatology, Duke University, Durham, North Carolina, USA., Bloomfeld R; Section of Gastroenterology, Atrium Health at Wake Forest Baptist, Winston-Salem, North Carolina, USA., Cairns A; Division of Colon and Rectal Surgery, Atrium Health at Wake Forest Baptist, Winston-Salem, North Carolina, USA., Mehta K; Department of Medicine, Duke University, Durham, North Carolina, USA., Patel P; Department of Medicine, Duke University, Durham, North Carolina, USA., Dziwis J; Section of Gastroenterology, Atrium Health at Wake Forest Baptist, Winston-Salem, North Carolina, USA.; Department of Medicine, Duke University, Durham, North Carolina, USA., Esckilsen S; University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Rahbar R; North Carolina Surgery, Raleigh, North Carolina, USA., Sadiq TS; North Carolina Surgery, Raleigh, North Carolina, USA., Hanson JS; Division of Gastroenterology and Hepatology, Atrium Health, Charlotte, North Carolina, USA., Herfarth HH; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.; Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2024 Feb 01; Vol. 15 (2), pp. e00670. Date of Electronic Publication: 2024 Feb 01.
DOI:	10.14309/ctg.0000000000000670
Abstrakt:	Introduction: Our understanding of the epidemiology of inflammatory conditions of the pouch and effectiveness of treatment is largely based on selected populations. We created a state-level registry to evaluate the incidence of pouchitis and the effectiveness of treatments used in an initial episode of pouchitis. Methods: In a state-level retrospective cohort of all patients undergoing proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis between January 1, 2018, and December 31, 2020, we evaluated the incidence of pouchitis and compared the proportion of patients developing recurrent pouchitis and chronic antibiotic-dependent pouchitis according to initial antibiotic therapy. Results: A total of 177 patients underwent surgery with 49 (28%) developing pouchitis within the 12 months after the final stage of IPAA. Patients with extraintestinal manifestations of inflammatory bowel disease (IBD) were significantly more likely to develop pouchitis within the first 12 months after IPAA (adjusted odds ratio 2.45, 95% confidence interval 1.03-5.81) after adjusting for family history of IBD (adjusted odds ratio 3.50, 95% 1.50-8.18). When comparing the proportion of patients who developed recurrent pouchitis or chronic antibiotic-dependent pouchitis with those who experienced an isolated episode of pouchitis, there were no significant differences among the initial antibiotic regimens used. Discussion: In a state-level examination of outcomes after IPAA for ulcerative colitis, patients with extraintestinal manifestations of IBD were more likely to develop pouchitis; however, the initial antibiotic regimen chosen did not seem to affect long-term outcomes. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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