Pouchitis

Overview

Pouchitis is swelling and irritation, called inflammation, in the lining of a pouch made during surgery to remove the colon. The pouch is made to treat a bowel disease called ulcerative colitis and some other diseases.

Many people with ulcerative colitis need to have their colons taken out. Surgeons use a procedure called ileoanal anastomosis (J-pouch) surgery to connect the bowel again after taking out the colon.

In J-pouch surgery, surgeons use the end of the small intestine, called the ileum, to make a pouch shaped like the letter J. Surgeons attach the pouch inside the body to the area just above the anus. The pouch holds stool before it leaves the body.

Pouchitis is a complication of J-pouch surgery. It happens in nearly one-half of the people who have the procedure.

Symptoms

Symptoms of pouchitis can include diarrhea, belly pain, joint pain, cramps and fever. Other symptoms include passing stool more often, stool leakage at night, trouble controlling stool passage and a strong urge to pass stool.

Causes

The cause of pouchitis is unknown. The condition appears to be due to an interaction between bacteria in the pouch and an underlying issue with the immune system.

Risk factors

Some factors that can increase the risk of developing pouchitis include:

• Having inflammatory bowel disease, also called IBD. Pouchitis happens more often in people who have underlying IBD, such as ulcerative colitis.
• Using nonsteroidal anti-inflammatory drugs, also called NSAIDs. Taking NSAIDS, such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), can contribute to the development of pouchitis.
• Having radiation therapy. Radiation therapy in the pelvic area increases the risk of getting pouchitis.

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