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.