Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on pouchitis in ulcerative colitis. Part 2: Treatment
Por:
Barreiro-de Acosta, M, Marin-Jimenez, I, Rodriguez-Lago, I, Guarner, F, Espin, E, Bradley, I, Gutierrez, A, Beltran, B, Chaparro, M, Gisbert, J, Nos, P and GETECCU
Publicada:
1 dic 2020
Ahead of Print:
27 jun 2020
Resumen:
Pouchitis treatment is a complex entity that requires a close medical and surgical relationship. The elective treatment for acute pouchitis is antibiotics. After a first episode of pouchitis it is recommended prophylaxis therapy with a probiotic mix, nevertheless it is not clear the use of this formulation for preventing a first episode of pouchitis after surgery. First-line treatment for chronic pouchitis is an antibiotic combination. The next step in treatment should be oral budesonide. Selected cases of severe, chronic refractory pouchitis may benefit from biologic agents, and anti-TNF alpha should be recommended as the first option, leaving the new biologicals for multi-refractory patients. Permanent ileostomy may be an option in severe refractory cases to medical treatment. (C) 2020 The Author(s). Published by Elsevier Espana, S.L.U.
Filiaciones:
Barreiro-de Acosta, M:
Hosp Clin Univ Santiago, Serv Aparato Digest, Unidad EII, Santiago De Compostela, Spain
Marin-Jimenez, I:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Serv Aparato Digest, Madrid, Spain
Rodriguez-Lago, I:
Hosp Galdakao, Serv Aparato Digest, Unidad EII, Galdakao, Spain
Inst Invest Sanitaria Biocruces Bizkaia, Baracaldo, Spain
Guarner, F:
Vall dHebron Inst Recerca VHIR, Grp Fisiol & Fisiopatol Digest, Barcelona, Spain
Espin, E:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Cirugia Gen, Unidad Cirugia Colorrectal, Barcelona, Spain
Bradley, I:
Hosp Manises, Serv Med Digest, Unidad EII, Valencia, Spain
:
Hosp Gen Univ Alicante, Serv Med Digest, Alicante, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Beltran, B:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ & Politecn La Fe, Serv Med Digest, Unidad EII, Valencia, Spain
Chaparro, M:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Univ Autonoma Madrid, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP, Serv Aparato Digest, Madrid, Spain
Gisbert, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Univ Autonoma Madrid, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP, Serv Aparato Digest, Madrid, Spain
Nos, P:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ & Politecn La Fe, Serv Med Digest, Unidad EII, Valencia, Spain
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