- Increased frequency, cramping, bleeding urgency, tenesmus, incontinence and fevers
- Clinical, endoscopic and histological diagnosis
- Cause unclear, likely related to bacterial overgrowth/local factors/ischaemia
- Extra-intestinal manifestations (PSC) and high pANCA linked with increased risk of pouchitis and chronic pouchitis
- If chronic or recurrent ?is dx actually Crohn’s
- Smoking and probiotics reduce risk
- Treatment - abx (Cipro and Met) +/- topical Mesalazine or steroid
- Surgery seldom helps and pouch excision is rarely needed
- Diversion doesnt always help
- Excision and recon can result in recurrence