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USC Surgery / Conditions / Pouchitis

Pouchitis is a condition that may occur after a particular surgery done for ulcerative colitis. Ulcerative colitis is a form of inflammatory bowel disease, or inflammation of the colon. It is similar to Crohn’s disease, but it tends to affect only the colon. The inflammation starts in the rectum and works backwards towards the end of the small intestine. It is associated with varying degrees of severity. While most patients with ulcerative colitis do not require surgery, it requires care of a specialized physician trained in the disease.

Surgery involves complete removal of the colon and rectum. Usually, the small intestine is then folded into a “J-pouch” and reconnected to the anus. This surgery usually requires a temporary bag to divert the stool, but once everything has healed, it can be reversed. Patients can learn to function with this new configuration and often lead normal lives. Some patients may also qualify for a minimally invasive approach to this kind of pouch surgery. After creation of the pouch, the area may become inflamed or irritated. This process is deemed “pouchitis.”

Signs and symptoms of pouchitis

The most common symptoms associated with pouchitis include:

  • Blood in the stool
  • Recurring rectal discomfort, pain or feeling of incomplete evacuation of stool
  • Abdominal pain
  • Diarrhea or increased number of bowel movements above baseline
  • Fever or chills
  • Episodes of incontinence or urgency to use the toilet

The diagnosis and evaluation of pouchitis is usually made on clinical grounds based on the symptoms described above. Your doctor may decide to insert a short scope into the pouch and take biopsies or tissue samples to examine under the microscope. This may help your doctor determine the severity of the disease and the most appropriate treatment options.

Related to Pouchitis

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.