Crohn's disease of the ileoanal pouch

Abstract

Crohn's disease of the ileoanal pouch is a known albeit infrequent outcome of restorative proctocolectomy with ileoanal reservoir for inflammatory bowel disease colitides. Although an adverse outcome, many patients will benefit from a combined medical-surgical multidisciplinary approach to pouch retention. In this review article, we will discuss inflammatory disorders of the body of the pouch and the rectal cuff which lay on a spectrum, including pouchitis, cuffitis and Crohn's disease of the ileoanal pouch. It is imperative that readers fully understand conditions on both sides of the spectrum as treatments often overlap and it is necessary to undergo many of the mentioned treatments, or at least consider them, before undergoing what can be complex, re-operative abdominopelvic surgery with permanent re-diversion with the pouch left in situ, pouch excision or rarely pouch revision. We will also discuss outcomes of intentional ileoanal pouch for isolated Crohn's colitis.