Clinical Practice Guideline Developed for Management of Pouchitis

FRIDAY, Jan. 19, 2024 (HealthDay News) -- In a clinical practice guideline issued by the American Gastroenterological Association (AGA) and published in the January issue of Gastroenterology, recommendations are presented for the management of pouchitis.

Edward L. Barnes, M.D., M.P.H., from the University of North Carolina at Chapel Hill, and colleagues developed recommendations for the prevention and treatment of pouchitis and cuffitis to support practitioners in their management of these conditions.

The guideline panel made nine conditional recommendations. The AGA suggests using antibiotics for treatment of pouchitis in patients with ulcerative colitis who have undergone ileal pouch-anal anastomosis and experience intermittent symptoms of pouchitis. Probiotics are suggested for the prevention of recurrent pouchitis in patients who experience recurrent episodes of pouchitis that respond to antibiotics. Chronic antibiotic therapy is suggested to prevent recurrent pouchitis in patients who experience recurrent pouchitis that responds to antibiotics but relapses after stopping antibiotics; however, advanced immunosuppressive therapies approved for treatment of inflammatory bowel disease are suggested for patients who are intolerant to antibiotics or who are concerned about the risks of long-term antibiotic therapy. Advanced immunosuppressive therapies are also suggested for patients with recurrent pouchitis with inadequate response to antibiotics; corticosteroids can also be considered for these patients.

"As providers we struggle to get insurance approval for medications to treat pouchitis, because it has not been a well-defined or recognized entity," coauthor Siddharth Singh, M.D., from the University of California San Diego in La Jolla, said in a statement. "Our intention with this guideline is to help improve access for patients and providers to use these advanced therapies."

Several authors disclosed ties to the pharmaceutical industry.

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