Therapeutic Areas

GI - Pouchitis

An ileal pouch anal anastomosis (IPAA) is a surgical procedure by which the small intestine is used to create an internal pouch as a reservoir for stool after colectomy in patients with ulcerative colitis who require surgical intervention.

In up to 40% of the patients with an IPAA, the lining of the internal pouch created as a reservoir becomes inflamed, presumably as a result of a change in bacterial flora composition and/or bile acid composition¹. Pouchitis can cause symptoms similar to ulcerative colitis, such as diarrhea, cramping, abdominal pain, bleeding, fever, dehydration and joint pain. There are no drugs currently approved for the treatment of pouchitis. The condition may be managed with a short course of antibiotics, including ciprofloxacin and metronidazole, but the inflammation often becomes recurrent or chronic. Although some patients respond to antibiotics, they often become antibiotic dependent or even resistant², Chronic use of antibiotics can be associated with adverse effects, such as an irreversible neuropathy due to metronidazole.³ Of patients with acute pouchitis, 61% will develop at least one recurrence.⁴ Better long term treatment options are needed.