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.

Last reviewed by a Cleveland Clinic medical professional on 01/16/2019.


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  • Shen B. Pouchitis: What Every Gastroenterologist Needs to Know. Clinical Gastroenterology and Hepatology, December 2013 Volume 11, Issue 12, Pages 1538–1549. DOI: https://doi.org/10.1016/j.cgh.2013.03.033
  • Achkar J-P, Al-Haddad M, Lashner B, et al. Differentiating Risk Factors for Acute and Chronic Pouchitis. Clinical Gastroenterology and Hepatology 2005;3:60–66.
  • Gionchetti P, Calafiore A, Riso D, et al. The role of antibiotics and probiotics in pouchitis. Ann Gastroenterol. 2012; 25(2): 100–105.

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