{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:18:18Z","timestamp":1788185898139,"version":"build-2803163510"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["K23DK127241"],"award-info":[{"award-number":["K23DK127241"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pouchitis is the most common complication after ileal pouch anal anastomosis (IPAA), yet symptoms are non-specific, and diagnosis typically requires pouchoscopy. Fecal calprotectin (FC) is an established inflammatory bowel disease biomarker, but optimal thresholds and diagnostic performance across distinct pouch phenotypes remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed an analysis of a prospectively maintained IPAA registry (2022-2025) at Mount Sinai Hospital. Adults with ulcerative colitis who had underwent total proctocolectomy with IPAA and had FC testing within\u2009\u00b190\u2009days of pouchoscopy were included. Phenotypes were categorized as normal pouch (NP), acute pouchitis (AP), chronic pouchitis (CP), or Crohn\u2019s disease\u2013like pouch inflammation (CDLPI). FC was compared across phenotypes and tested for associations with endoscopic Pouchitis Disease Activity Index (PDAI) sub-score, histologic activity, and symptoms using non-parametric tests, Spearman correlation, log-linear regression, and receiver operating characteristic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 163 patients, FC differed significantly across pouch phenotypes (P\u2009&amp;lt;.01) with a median value of 50.5\u2009\u00b5g\/g in NP, 244\u2009\u00b5g\/g in AP, 370.5\u2009\u00b5g\/g in CP, and 231.5\u2009\u00b5g\/g in CDLPI. FC distinguished between inflammatory and normal pouches with an area under the curve (AUC) of 0.82, with an optimal threshold of \u223c167\u2009\u00b5g\/g (specificity, 94%). FC correlated significantly with endoscopic PDAI sub-scores (Spearman \u03c1\u2009=\u20090.45, P\u2009&amp;lt;.001), and predicted severe endoscopic activity with an AUC of 0.82 and an optimal cutoff of 280\u2009\u00b5g\/g.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FC is accurate for detecting and grading pouch inflammation. Thresholds near 167 and 280\u2009\u00b5g\/g reliably discriminate normal from inflamed pouches and mild from severe endoscopic disease, respectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag029","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T12:49:17Z","timestamp":1770382157000},"page":"1298-1303","source":"Crossref","is-referenced-by-count":1,"title":["Fecal calprotectin is an accurate noninvasive screening tool for pouchitis"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8076-9706","authenticated-orcid":false,"given":"S\u00e9rgio","family":"Bronze","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Department, Unidade Local de Sa\u00fade de Santa Maria , Lisbon,","place":["Portugal"]},{"name":"Faculdade de Medicina de Lisboa, Universidade de Lisboa , Lisboa,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0445-7588","authenticated-orcid":false,"given":"Susanne","family":"Ibing","sequence":"additional","affiliation":[{"name":"Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darwin","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela Reyes","family":"Mercedes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-950X","authenticated-orcid":false,"given":"Maia","family":"Kayal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"2026070620124581400_izag029-B1","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1093\/ecco-jcc\/jjy040","article-title":"Colectomy rates in ulcerative colitis are low and decreasing: 10-year follow-up data from the Swiss IBD cohort study","volume":"12","author":"Parragi","year":"2018","journal-title":"J Crohns Colitis"},{"key":"2026070620124581400_izag029-B2","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.cgh.2017.06.016","article-title":"Natural history of adult ulcerative colitis in population-based cohorts: a systematic review","volume":"16","author":"Fumery","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026070620124581400_izag029-B3","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1016\/j.cgh.2020.06.035","article-title":"Incidence, risk factors, and outcomes of pouchitis and pouch-related complications in patients with ulcerative colitis","volume":"19","author":"Barnes","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026070620124581400_izag029-B4","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1053\/j.gastro.2023.10.015","article-title":"AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders","volume":"166","author":"Barnes","year":"2024","journal-title":"Gastroenterology"},{"key":"2026070620124581400_izag029-B5","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1093\/ibd\/izab124","article-title":"Disease activity indices for pouchitis: a systematic review","volume":"28","author":"Sedano","year":"2022","journal-title":"Inflamm Bowel Dis"},{"key":"2026070620124581400_izag029-B6","first-page":"53","article-title":"The use of fecal calprotectin in inflammatory bowel disease","volume":"13","author":"Bjarnason","year":"2017","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"2026070620124581400_izag029-B7","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/j.cgh.2015.05.038","article-title":"Level of fecal calprotectin correlates with endoscopic and histologic inflammation and identifies patients with mucosal healing in ulcerative colitis","volume":"13","author":"Theede","year":"2015","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026070620124581400_izag029-B8","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1159\/000531654","article-title":"Associations between pouchitis and fecal calprotectin after restorative proctocolectomy in patients with ulcerative colitis","volume":"8","author":"Uchino","year":"2023","journal-title":"Inflamm Intest Dis"},{"key":"2026070620124581400_izag029-B9","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1007\/s00384-020-03669-w","article-title":"The role of fecal calprotectin in the diagnosis of acute pouchitis following IPAA for ulcerative colitis: a systematic clinical review","volume":"35","author":"McKechnie","year":"2020","journal-title":"Int J Colorectal Dis"},{"key":"2026070620124581400_izag029-B10","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1016\/j.cgh.2021.11.012","article-title":"Fecal calprotectin is increased in pouchitis and progressively increases with more severe endoscopic and histologic disease","volume":"20","author":"Ollech","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026070620124581400_izag029-B11","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1093\/ecco-jcc\/jjab125","article-title":"Accuracy of gastrointestinal ultrasound and calprotectin in the assessment of inflammation and its location in patients with an ileoanal pouch","volume":"16","author":"Ardalan","year":"2022","journal-title":"J Crohns Colitis"}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/7\/1298\/67281054\/izag029.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/7\/1298\/67281054\/izag029.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:12:52Z","timestamp":1783383172000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/32\/7\/1298\/8512320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":11,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,3,9]]},"published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izag029","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,3,9]]}}}