{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:03:24Z","timestamp":1790114604852,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,12,23]],"date-time":"2016-12-23T00:00:00Z","timestamp":1482451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Restorative proctocolectomy with ileal pouch anal anastomosis (<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content>) is considered the procedure of choice in patients with ulcerative colitis (<jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>) refractory to medical therapy. The incidence of pouchitis is 40% at 5 years. Ten to 15% of patients with pouchitis experience chronic pouchitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the efficacy of medical therapies for the treatment of chronic refractory pouchitis in patients undergoing <jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic computer\u2010assisted search of the on\u2010line bibliographic database <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> was performed between 1966 and February 2016. All original studies reporting remission rates following medical treatment for chronic pouchitis were included. All study designs were considered. Remission was defined according to the individual study. Remission endpoints ranged from 15 days to 10 weeks. Chronic pouchitis was defined by each study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010one papers were considered eligible. Results from all studies combined suggested that overall remission was obtained in 59% of patients (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 44\u201373%). Antibiotics significantly induced remission in patients with chronic pouchitis with 74% remission rate (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>:56\u201393%), (<jats:italic>P<\/jats:italic> &lt; 0.001). Biologics significantly induced remission in patients with chronic pouchitis with 53% remission rate (95% CI:30\u201376%), (<jats:italic>P<\/jats:italic> &lt; 0.001). Steroids, bismuth, elemental diet and tacrolimus all can induce remission but failed to achieve significance. Faecal microbiota transplantation in a single study was not found to achieve remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment of chronic refractory pouchitis remains difficult and is largely empirical. Larger randomised controlled trials will help aid the management of chronic pouchitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13905","type":"journal-article","created":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T19:47:04Z","timestamp":1482608824000},"page":"581-592","source":"Crossref","is-referenced-by-count":118,"title":["Systematic review with meta\u2010analysis: the management of chronic refractory pouchitis with an evidence\u2010based treatment algorithm"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-0316","authenticated-orcid":false,"given":"J. P.","family":"Segal","sequence":"first","affiliation":[{"name":"St. Mark's Hospital Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. S.","family":"Ding","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Worley","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mclaughlin","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Preston","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. D.","family":"Faiz","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. L.","family":"Hart","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,23]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"51","article-title":"Pouchitis: definition, risk factors, frequency, natural history, classification, and public health perspective","author":"Sandborn WJ","year":"1996","journal-title":"Trends Inflamm Bowel Dis Ther"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6412-9"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02093783"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1999.00553.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200111000-00004"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01203.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-995784"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.03.033"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3923\/ijp.2010.826.835"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000367"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MIB.0000437495.30052.be"},{"key":"e_1_2_10_13_1","first-page":"CD001176","article-title":"Treatment and prevention of pouchitis after ileal pouch\u2010anal anastomosis for chronic ulcerative colitis","volume":"11","author":"Singh S","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_14_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JP"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym018"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2004.00746.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0828-3"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03306.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.12.001"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.00253.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.00217.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.01863.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31829ebd83"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21037"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(10)61511-9"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.02.018"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21821"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3283525a7b"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(13)63341-7"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2012.07.009"},{"key":"e_1_2_10_31_1","first-page":"239","article-title":"Management of refractory fistulizing pouchitis with infliximab","volume":"8","author":"Viscido A","year":"2004","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.53.2793"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20052"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.01.002"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X10370611"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13197"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13905","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T11:37:49Z","timestamp":1694432269000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,23]]},"references-count":35,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1111\/apt.13905"],"URL":"https:\/\/doi.org\/10.1111\/apt.13905","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,23]]}}}