{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:03:13Z","timestamp":1790114593633,"version":"4.0.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T00:00:00Z","timestamp":1548806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Nickolas Bunn Boddie, Sr."},{"name":"Lucy Mayo Boddie Foundation"},{"DOI":"10.13039\/100011684","name":"Crohn\u2019s and Colitis Foundation","doi-asserted-by":"publisher","award":["567497"],"award-info":[{"award-number":["567497"]}],"id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011684","name":"Crohn\u2019s and Colitis Foundation","doi-asserted-by":"publisher","award":["568735"],"award-info":[{"award-number":["568735"]}],"id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK034987"],"award-info":[{"award-number":["P30DK034987"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A subset of patients who undergo total proctocolectomy with ileal pouch\u2013anal anastomosis (IPAA) creation for ulcerative colitis (UC) will later develop Crohn\u2019s disease (CD) of the pouch, which has been associated with significant morbidity. We aimed to analyze the incidence of CD of the pouch and to review the existing diagnostic criteria utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search performed through March 1, 2018, identified 12 studies that reported the incidence of CD of the pouch after IPAA for UC or indeterminate colitis (IC). We compiled all diagnostic criteria utilized in these studies and then performed a meta-analysis using random effects modeling to estimate the overall incidence of CD of the pouch in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4843 patients with an IPAA for UC or IC, 10.3% of patients were ultimately diagnosed with CD of the pouch (95% confidence interval [CI], 6.1%\u201315.4%). The most commonly reported diagnostic criteria were (1) presence of fistula\/fistulae, (2) stricture involving the pouch or prepouch ileum, and (3) presence of prepouch ileitis. In a secondary analysis, excluding those studies that included patients with a preoperative diagnosis of IC, the incidence of CD of the pouch was 12.4% (95% CI, 9.0%\u201316.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The estimated incidence of 10.3% will assist gastroenterologists and surgeons in preoperative counseling regarding the potential to develop CD of the pouch. There is an unmet need for common diagnostic criteria for a more standardized approach to the diagnosis of CD of the pouch.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izz005","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T06:40:44Z","timestamp":1548830444000},"page":"1474-1480","source":"Crossref","is-referenced-by-count":107,"title":["The Incidence and Definition of Crohn\u2019s Disease of the Pouch: A Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"25","author":[{"given":"Edward L","family":"Barnes","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharati","family":"Kochar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary R","family":"Jessup","sequence":"additional","affiliation":[{"name":"School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans H","family":"Herfarth","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"},{"name":"Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,30]]},"reference":[{"key":"2019082011451847300_CIT0001","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders","volume":"11","author":"Magro","year":"2017","journal-title":"J Crohns Colitis"},{"key":"2019082011451847300_CIT0002","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/DCR.0000000000000030","article-title":"Practice parameters for the surgical treatment of ulcerative colitis","volume":"57","author":"Ross","year":"2014","journal-title":"Dis Colon Rectum"},{"key":"2019082011451847300_CIT0003","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/bjs.5464","article-title":"Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis","volume":"94","author":"Hahnloser","year":"2007","journal-title":"Br J Surg"},{"key":"2019082011451847300_CIT0004","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1097\/SLA.0000000000001406","article-title":"Restorative proctocolectomy and ileal pouch-anal 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