Today, 10-15 percent of people with an ileal pouch anal-anastomosis (IPAA) are affected by chronic pouchitis, a chronic inflammation in the pouch having a severe impact on their quality of life. The number is significant as an IPAA is the most common treatment for people with ulcerative colitis when medications fail to control their symptoms. 

It is our hope that our new study on chronic pouchitis will help these individuals in future. The study has just been published in The American Journal of Gastroenterology and shows that persons with chronic pouchitis can be identified based on antibiotic use patterns utilized after an initial episode of pouchitis.

In the study we have rethought how to identify high-risk patients, using sequence analysis to identify clusters of antibiotic use in the first year after an individual’s first episode of pouchitis. The clusters indicate that there are high-risk phenotypes apparent even after the first episode of pouchitis, shortly after IPAA surgery.

Our findings suggest the need for improved risk stratification at the time of IPAA surgery. Hopefully, this will help reframe the conversation about high-risk patients in the future, leading to even more insights on this particular group, and potentially, reducing the need for ongoing antibiotic treatment.

Authors

Edward Barnes
Anastasia Karachalia Sandri
Tine Jess