{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:43:15Z","timestamp":1785328995366,"version":"3.55.0"},"reference-count":30,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ugeskr L\u00e6ger"],"abstract":"<jats:p>Pouchitis is the most common complication following ileal pouch-anal anastomosis. It is characterized by pouch inflammation and symptoms resembling ulcerative colitis. The aetiology is thought to involve a combination of genetic factors, a dysregulated immune response, and alterations in the gut microbiome. Pouchitis is classified as acute if symptoms &lt; 4 weeks or chronic if symptoms &gt; 4 weeks. Acute pouchitis is typically treated with antibiotics, while chronic pouchitis may require cyclic antibiotics or immunomodulatory therapy. This review indicates that more research is needed to improve understanding and treatment.<\/jats:p>","DOI":"10.61409\/v01250033","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T02:02:30Z","timestamp":1751421750000},"page":"1-12","source":"Crossref","is-referenced-by-count":1,"title":["Pouchitis"],"prefix":"10.61409","author":[{"given":"Louise","family":"Thomsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sine","family":"Jacobsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"T\u00f8ttrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"40208","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Shen B, Kochhar GS, Rubin DT, et al. Treatment of pouchitis, Crohn's disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium. Lancet Gastroenterol Hepatol. 2022;7(1):69-95. https:\/\/doi.org\/10.1016\/S2468-1253(21)00214-4","DOI":"10.1016\/S2468-1253(21)00214-4"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Zaffaroni G, Mannucci A, Koskenvuo L, et al. Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision. Br J Surg. 2024;111(5). https:\/\/doi.org\/10.1093\/bjs\/znae070","DOI":"10.1093\/bjs\/znae070"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Hata K, Ishihara S, Nozawa H, et al. Pouchitis after ileal pouch-anal anastomosis in ulcerative colitis: diagnosis, management, risk factors, and incidence. 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Nat Rev Gastroenterol Hepatol. 2024;21(7):463-476. https:\/\/doi.org\/10.1038\/s41575-024-00920-5","DOI":"10.1038\/s41575-024-00920-5"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Alenzi M, Schildkraut T, Hartley I, et al. The aetiology of pouchitis in patients with inflammatory bowel disease. Therap Adv Gastroenterol. 2024;17:17562848241249449. https:\/\/doi.org\/10.1177\/17562848241249449","DOI":"10.1177\/17562848241249449"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Shen B. Pouchitis: what every gastroenterologist needs to know. Clin Gastroenterol Hepatol. 2013;11(12):1538-1549. https:\/\/doi.org\/10.1016\/j.cgh.2013.03.033","DOI":"10.1016\/j.cgh.2013.03.033"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Shen B, Goldblum JR, Hull TL, et al. Clostridium difficile-associated pouchitis. 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