{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T05:41:16Z","timestamp":1696398076403},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,11,21]],"date-time":"2013-11-21T00:00:00Z","timestamp":1384992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,12]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>Reservoir ileitis (pouchitis) is the most common complication after pelvic pouch surgery for ulcerative colitis and the aetiology remains largely unknown. The anal transition zone (ATZ<\/jats:styled-content>) contains the only remaining colonic epithelium after ileal pouch anal anastomosis (IPAA<\/jats:styled-content>) and may provide important clues as to whether ulcerative colitis and pouchitis share a common pathogenesis. The aim of this study was to evaluate longitudinally the long\u2010term histological changes in the ATZ<\/jats:styled-content> and their relationship to the incidence of pouchitis.<\/jats:p><\/jats:sec>Method<\/jats:title>Patients with a double\u2010stapled IPAA<\/jats:styled-content> for ulcerative colitis at an academic medical centre with at least 10\u00a0years of clinical and histological follow\u2010up were identified from a prospective database. Annual ATZ<\/jats:styled-content> and pouch biopsies were taken and interpreted by two expert gastrointestinal pathologists. ATZ<\/jats:styled-content> histological variability score, the incidence of pouchitis, and function were correlated over time. ATZ<\/jats:styled-content> biopsies were scored from one to three based on the extent of inflammation.<\/jats:p><\/jats:sec>Results<\/jats:title>Sixteen of the 114 patients having IPAA<\/jats:styled-content> fulfilled the criteria for admission to the study. There were 179 biopsies of the ATZ<\/jats:styled-content>. All exhibited variability in ATZ<\/jats:styled-content> histology over time and 81% had a 2\u2010unit change in their inflammatory score. There was no correlation between pouchitis and histological severity score of the ATZ<\/jats:styled-content>. Similarly, function over time did not vary with the intensity of ATZ<\/jats:styled-content> inflammation.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>ATZ<\/jats:styled-content> inflammation varies substantially over time in most patients. But these changes from year to year did not correlate with function or the occurrence of pouchitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12322","type":"journal-article","created":{"date-parts":[[2013,6,18]],"date-time":"2013-06-18T18:40:44Z","timestamp":1371580844000},"page":"1493-1498","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The natural history of anal transition zone inflammation and possible relationship to pouchitis: a long\u2010term longitudinal study"],"prefix":"10.1111","volume":"15","author":[{"given":"M.","family":"Wasserman","sequence":"first","affiliation":[{"name":"Department of Surgery University of Vermont College of Medicine Burlington VT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Hyman","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Vermont College of Medicine Burlington VT 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