دورية أكاديمية
Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease.
| العنوان: | Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease. |
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| المؤلفون: | Akiyama S; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Ollech JE; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Cohen NA; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Traboulsi C; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Rai V; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Glick LR; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Yi Y; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Runde J; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Cohen RD; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Olortegui KBS; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Hurst RD; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Umanskiy K; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Shogan BD; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Hyman NH; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Rubin MA; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Dalal SR; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Sakuraba A; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Pekow J; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Chang EB; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA., Rubin DT; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA. |
| المصدر: | Inflammatory bowel diseases [Inflamm Bowel Dis] 2024 Jun 25. Date of Electronic Publication: 2024 Jun 25. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9508162 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-4844 (Electronic) Linking ISSN: 10780998 NLM ISO Abbreviation: Inflamm Bowel Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [Oxford] : Oxford University Press Original Publication: New York, NY : Raven Press, c1995- |
| مستخلص: | Background: Patients with inflammatory bowel disease (IBD) who undergo proctocolectomy with ileal pouch-anal anastomosis may develop pouchitis. We previously proposed a novel endoscopic classification of pouchitis describing 7 phenotypes with differing outcomes. This study assessed phenotype transitions over time. Methods: We classified pouch findings into 7 main phenotypes: (1) normal, (2) afferent limb (AL) involvement, (3) inlet (IL) involvement, (4) diffuse, (5) focal inflammation of the pouch body, (6) cuffitis, and (7) pouch-related fistulas noted more than 6 months after ileostomy takedown. Among 2 endoscopic phenotypes, the phenotype that was first identified was defined as the primary phenotype, and the phenotype observed later was defined as the subsequent phenotype. Results: We retrospectively reviewed 1359 pouchoscopies from 426 patients (90% preoperative diagnosis of ulcerative colitis). The frequency of primary phenotype was 31% for AL involvement, 42% for IL involvement, 28% for diffuse inflammation, 72% for focal inflammation, 45% for cuffitis, 18% for pouch-related fistulas, and 28% for normal pouch. The most common subsequent phenotype was focal inflammation (64.8%), followed by IL involvement (38.6%), cuffitis (37.8%), AL involvement (25.6%), diffuse inflammation (23.8%), normal pouch (22.8%), and pouch-related fistulas (11.9%). Subsequent diffuse inflammation, pouch-related fistulas, and AL or IL stenoses significantly increased the pouch excision risk. Patients who achieved subsequent normal pouch were less likely to have pouch excision than those who did not (8.1% vs 15.7%; P = .15). Conclusions: Pouch phenotype and the risk of pouch loss can change over time. In patients with pouch inflammation, subsequent pouch normalization is feasible and associated with favorable outcome. (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| معلومات مُعتمدة: | P30 DK42086 United States DK NIDDK NIH HHS; RC2 DK122394 United States DK NIDDK NIH HHS; GI Research Foundation of Chicago |
| فهرسة مساهمة: | Keywords: Chicago classification of pouchitis; pouch normalization; pouch outcome; pouchitis Local Abstract: [plain-language-summary] Endoscopic pouch phenotypes can change over time and subsequent development of diffuse inflammation, pouch-related fistulas, and afferent limb/inlet stenoses significantly worsen pouch outcomes. In patients with pouch inflammation, subsequent pouch normalization is feasible and associated with favorable outcomes. |
| تواريخ الأحداث: | Date Created: 20240625 Latest Revision: 20240625 |
| رمز التحديث: | 20240625 |
| DOI: | 10.1093/ibd/izae106 |
| PMID: | 38916136 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1536-4844 |
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| DOI: | 10.1093/ibd/izae106 |