Pouchitis

Diagnosis

To diagnose pouchitis, a healthcare professional typically begins with a review of your medical history and a physical exam.

Additional tests may be used to confirm the diagnosis:

• Lab tests, including blood tests to check for other medical conditions and stool tests to look for infection. These results help guide the choice of antibiotics.

• Endoscopy, which involves a tiny camera on a flexible tube to visually examine the ileal pouch. During this procedure, a biopsy may be taken for testing.

• Imaging tests, such as MRI or CT scans, to identify underlying causes of symptoms.

Treatment

Treatment for pouchitis usually starts with antibiotics:

• Most people improve within 1 to 2 days of starting antibiotics.

• A full course typically lasts 10 to 14 days, though longer courses may be needed in some cases.

• For frequent flare-ups, ongoing maintenance antibiotic therapy may be recommended. Probiotics can also help reduce the risk of recurrence.

Surgery is rarely required but may be necessary if pouchitis does not respond to treatment. In these cases, surgeons may remove the pouch and perform a permanent ileostomy.