What is the prognosis (outlook) for someone with pouchitis?
The prognosis for a patient with pouchitis depends on each patient’s illness:
- Patients who need antibiotics will have long-term therapy with either antibiotics or probiotics.
- Antibiotic-resistant pouchitis can be difficult to treat and is a common reason for pouch failure. In such cases, removal of the pouch or a permanent diversion may be necessary. Some patients may also experience pouchitis after the diversion, which needs to be further evaluated and treated if necessary.
- When antibiotics fail, it is important to look for other causes for pouchitis, such as the use of nonsteroidal anti-inflammatory drugs (NSAIDs), infections, autoimmune diseases, reduced blood flow to the pouch, or inflammatory polyps.
- For patients without an obvious cause of pouchitis, treatment possibilities include antibiotics in combination with corticosteroids, immunosuppressants, or biological therapy.
One potential problem with using antibiotics over a long period of time is that the bacteria may adapt and become resistant to the antibiotics.