69.Role of intestinal bacteria in the pathogenesis of pouchitis

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1、REVIEWARTICLERoleofIntestinalBacteriainthePathogenesisofPouchitisDaisyBatista,MDandLauraRaffals,MD,MSAbstract:Pouchitisisacommoncomplicationseeninpatientswithulcerativecolitiswhoundergototalproctocolectomywithilealpouchanalanastomosis.Bacteriaseemtoplayanimportantroleinthedevelopmentofpouchitis,a

2、lthoughthisroleisnotwelldefined.Becausetechnologyhasadvanced,weareabletoapplymoleculartechniquestodescribethestructureandfunctionofthepouchmicrobialcommunity.Inrecentyears,severalstudieshavebeenperformedcomparingthepouchmicrobiotainpatientswithulcerativecolitiswithhealthypouchesandpouchitis.Manyof

3、thesestudieshavesuggestedthatpouchitisischaracterizedbydysbiosisand/ordecreasedmicrobialdiversity.Therehasnotbeenaclearpatternidentifyingapathogenicorganismoragroupoforganismsresponsibleforpouchitis.Thisreviewsummarizesrecentstudiesexploringthepouchmicrobiotainhealthanddisease,therelationshipofba

4、cterialmetabolitesandpouchitis,andtheroleofantibioticsandprobioticsforthetreatmentandpreventionofpouchitis.(InflammBowelDis2014;20:1481–1486)heprevalenceofulcerativecolitis(UC)hasbeenreportedtoconditionsaffectingthepouch,suchaspouchischemia,Crohn’sT1beashighas249per100,000personsinNorthAmerica.dis

5、easeofthepouch,cuffitis,infectionssuchascytomegalovirus,Approximately,30%ofpatientswithUCgoontorequiretotalorlesscommonlyautoimmuneenteropathy.Incaseswherethere2proctocolectomyafter15yearsofdisease.Theindicationforisasuspicionformechanicalcomplicationssuchasafistulaorsurgeryisoftenmedicallyrefracto

6、rydiseaseorthedevelopmentstricture,abdominalimagingwithcontrastpouchogram,com-ofdysplasiaorcolorectalcancer.Thesurgicaltreatmentofchoiceputedtomography,ormagneticresonanceenterographycanbeformanypatientsistotalproctocolectomywithcreationofanilealhelpfultodelineatetheanatomyofthepouch,identifycomp

7、lica-pouchanalanastomosis(IPAA)(Fig.1).Thisprocedurehastionsinvolvingthepouch,anddeterminetheextentandnatureofgreatlyenhancedthequalityoflifeformanypatientsandallowsinflammation.patientstoavoidtheneedforapermanentileost