Acute pouchitis and deficiencies of fuel

Sagar, P. M.; Taylor, Ben; Godwin, P. G. R.; Holdsworth, P. J.; Johnston, D.; Lewis, Wyn G.; Miller, Andrew; Quirke, Philip; Williamson, M. E. R.

doi:10.1007/bf02148848

Cited by 41 publications

(20 citation statements)

References 21 publications

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“…Bacterial overgrowth disproportionately favors anaerobes, leading to bacterial dysbiosis, another purported cause of pouchitis [37]. Overgrowth or dysbiosis can lead to deficiencies in essential nutrients, such as butyrate [38] and glutamine [39], both purportedly required for optimal enterocyte function. In addition, the overgrowth of bacteria, especially anaerobes, can catalyze the excess production of secondary bile acids [40] not typically present in high concentrations in the ileum.…”

Section: Discussionmentioning

confidence: 99%

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stucchi

Shebani

Reed

et al. 2010

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stucchi

Shebani

Reed

et al. 2010

Journal of Surgical Research

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“…They showed that the ileal J pouch becomes significantly inflamed after 30 days and DSS can be successfully used to reproducibly exacerbate ileal pouch inflammation and produce accompanying diarrhea, mucosal ulcerations, and rectal bleeding, similar to clinical pouchitis. It is well known that fecal stasis has been directly implicated in bacterial overgrowth [29] and bacterial dysbiosis [30]. In the Shebani study both aerobes and anaerobes overgrow the ileal pouch by 30 days.…”

Section: Discussionmentioning

confidence: 99%

“…In the Shebani study both aerobes and anaerobes overgrow the ileal pouch by 30 days. This atypical bacterial environment in the ileal J pouch can predispose ileal enterocytes to a number of pathophysiological conditions purportedly associated with pouchitis, including SCFA deficiencies [30]. Such nutrient alterations have been shown to compromise mucosal homeostasis, epithelial integrity, and barrier function [31].…”

Section: Discussionmentioning

confidence: 99%

Partially Hydrolyzed Guar Gum Attenuates the Severity of Pouchitis in a Rat Model of Ileal J Pouch-Anal Anastomosis

et al. 2008

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We aimed to evaluate the efficacy of treatment with partially hydrolyzed guar gum (PHGG) using a rat model of ileal pouch-anal anastomosis and pouchitis. In the J pouch groups, tissue myeloperoxidase activities were significantly higher than native myeloperoxidase activities (P = 0.020; P = 0.015; P = 0.004, respectively). A statistically significant difference in total histological score was detected in the J pouch + 5% dextran sulfate sodium (DSS) group, compared to the J pouch control and the J pouch + 5% DSS + PHGG groups (P < 0.01 and P < 0.01, respectively). There was a significant overgrowth of aerobes and anaerobes in the J pouch + 5% DSS group. This study demonstrated that rectal administration of PHGG attenuates the severity of pouchitis in a rat model. In conclusion, PHGG may be an additional therapeutic strategy for the treatment of pouchitis.

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“…Possible causes are fecal stasis resulting in bacterial overgrowth and infection 12 , microbial imbalance 13 , production of volatile fatty acids 14,15 , ischemia 14 , oxygen free radical injury 16 , nitric oxide 17 , deprivation of short chain fatty acids 18,19 , and extracolonic manifestation of ulcerative colitis. Penna et al 20 reported a strong correlation between primary sclerosing cholangitis and pouchitis, suggesting a common link in their pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

et al. 2003

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Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS:Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS:The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later.CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.

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Acute pouchitis and deficiencies of fuel

Abstract: Deficiency of SCFA is implicated in acute pouchitis.

Cited by 41 publications

References 21 publications

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Partially Hydrolyzed Guar Gum Attenuates the Severity of Pouchitis in a Rat Model of Ileal J Pouch-Anal Anastomosis

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

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