Pouchitis
Medically reviewed by Drugs.com. Last updated on May 6, 2024.
What is pouchitis?
Pouchitis is inflammation in your ileal pouch. Pouchitis is common after ileal pouch surgery. You may only have symptoms 1 time, or symptoms may come back again after treatment. Acute pouchitis lasts under 4 weeks. Pouchitis is chronic if it lasts 4 weeks or longer.
What increases my risk for pouchitis?
- Inflammatory bowel disease, such as ulcerative colitis or Crohn disease
- Autoimmune or inflammatory disease, such as rheumatoid arthritis or sclerosing cholangitis
- A bacterial infection that is resistant to antibiotics, such as C. diff
- Long-term use of NSAID medicines, such as ibuprofen
- A viral or fungal infection that causes inflammation
- Weakened immune system
What are the signs and symptoms of pouchitis?
- Lower abdominal pain or cramps
- Diarrhea or bowel movement leakage, especially at night
- More bowel movements than usual, or a strong urge to have a bowel movement
- Blood in your bowel movements
- Joint pain, fever, and chills
How is pouchitis diagnosed?
Your healthcare provider will examine you. The provider will ask about your symptoms and health history. You may be given contrast liquid before some of the following tests. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
- Blood and urine tests may show signs of infection or inflammation.
- Pouchography is a type of x-ray. Your provider will inject contrast into your pouch. The contrast material helps the pouch show up in the pictures.
- CT scan or MRI pictures may be used to find problems with your pouch or in your intestines. Do not enter the MRI room with anything metal. The MRI machine uses a powerful magnet. Metal may cause serious injury from the magnet.
- Pouchoscopy may be used to check inside the pouch with a scope (thin, flexible tube). Tissue samples may also be taken.
How is pouchitis treated?
Antibiotics may be given to treat a bacterial infection. Probiotics may be given to restore the balance between certain types of bacteria in your intestines. Other medicines may be used to decrease inflammation or control your immune system.
Treatment options
The following list of medications are related to or used in the treatment of this condition.
How can I manage or prevent pouchitis?
- Do not take NSAID medicines, including aspirin and ibuprofen. NSAIDs can cause flare-ups.
- Eat a variety of healthy foods. Healthy foods include fruit, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish. Your healthcare provider or a dietitian can help you create a meal plan that is right for you.
- Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. For most people, water, juice, and milk are good choices. Do not drink alcohol. Alcohol can make your symptoms worse.
- Be physically active, as directed. Physical activity helps prevent constipation and keep your colon healthy. Ask about the best exercise plan for you.
When should I seek immediate care?
- You have severe diarrhea.
- You are not able to have a bowel movement.
- You cannot stop vomiting.
- You have severe abdominal pain, a fever, and your abdomen is larger than usual.
- You have new or increased blood in your bowel movements.
When should I call my doctor?
- Your symptoms get worse or do not go away with medicine.
- You have questions or concerns about your condition or care.
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Further information
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