{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:26:58Z","timestamp":1786681618902,"version":"build-2736575974"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK127157-01"],"award-info":[{"award-number":["K23DK127157-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complications such as intermittent pouchitis (IP) and chronic inflammatory disorders of the pouch (CP) are common after ileal pouch-anal anastomosis (IPAA), particularly among patients with both ulcerative colitis and primary sclerosing cholangitis (PSC). There are no standardized approaches for prophylaxis against these complications for patients with PSC undergoing IPAA. We compared outcomes among patients with PSC and IPAA who received antibiotic or immunosuppressive therapies to those who did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We designed a retrospective cohort study that included patients with ulcerative colitis and PSC from 7 tertiary care centers that underwent IPAA between 1994 and 2023. Patients were categorized on whether they received medications following IPAA that may provide primary prophylactic benefit, such as antibiotics, probiotics, immunomodulators, or biologic medications; and the proportion of patients developing IP and CP was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 172 patients were included in the cohort, and 13 (7.6%) patients received antibiotics or immunosuppressant medications. Antibiotics and probiotics were the most common therapy (5 patients, 2.9%), followed by biologics, small-molecule inhibitors, immunomodulators, or mesalamine (all 1 patient, 0.6%). Compared to patients not receiving antibiotics or immunosuppression, patients receiving antibiotics or immunosuppression were significantly less likely to develop IP (69.2% vs 91.2%; P = .03; odds ratio 0.22; 95% CI, 0.06-0.80) and CP (23.1% vs 56.0%, P\u2009=\u20090.04; OR 0.24, 95% CI, 0.06-0.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort of patients with ulcerative colitis and PSC undergoing IPAA, usage of concomitant antibiotics or immunosuppression was low. However, use of concomitant antibiotics or immunosuppression may decrease the burden of inflammatory conditions of the pouch in these high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/crocol\/otag091","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:24:20Z","timestamp":1785756260000},"source":"Crossref","is-referenced-by-count":0,"title":["Continued concomitant antibiotic or immunosuppression therapies reduce the risk of pouchitis among patients with ileal pouch-anal anastomosis and primary sclerosing cholangitis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2094-7181","authenticated-orcid":false,"given":"John P","family":"Haydek","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2231-2884","authenticated-orcid":false,"given":"Priscila","family":"Santiago","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Carter","family":"Powers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Cleveland Clinic , Cleveland, OH,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latchmin","family":"Ruplall","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NYU Langone Health , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoang Anh","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Causey","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elhawary","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NYU Langone Health , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5737-1302","authenticated-orcid":false,"given":"Taylor","family":"Karl","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Colorado School of Medicine , Aurora, CO,","place":["United 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States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-5386","authenticated-orcid":false,"given":"Shannon","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NYU Langone Health , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3585-9643","authenticated-orcid":false,"given":"Sara","family":"Horst","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6021-0419","authenticated-orcid":false,"given":"Frank I","family":"Scott","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Colorado School of Medicine , Aurora, CO,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-2758","authenticated-orcid":false,"given":"Millie D","family":"Long","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina , Chapel Hill, NC,","place":["United States"]},{"name":"Center for Gastrointestinal Biology and Disease, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5267-2592","authenticated-orcid":false,"given":"Laura","family":"Raffals","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-8796","authenticated-orcid":false,"given":"Edward 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composition in patients with chronic pouchitis","volume":"30","author":"Santiago","year":"2024","journal-title":"Inflamm Bowel Dis"},{"key":"2026081323315034100_otag091-B9","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.cgh.2022.04.015","article-title":"Increasing incidence of pouchitis between 1996 and 2018: a population-based Danish cohort study","volume":"21","author":"Barnes","year":"2023","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Crohn\u2019s &amp; Colitis 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