ECCO Topical Review on Pouch Disorders

Maia Kayal; Gabriele Bislenghi; Michel Adamina; Zaid S Ardalan; Nicolas Avellaneda; Anthony de Buck van Overstraeten; Marjolijn Duijvestein; Maria Manuela Estevinho; Federica Furfaro; Ailsa L Hart; Stefan Holubar; Triana Lobaton; Jacob Ollech; Stephan R Vavricka; Mark Ferrante

doi:10.1093/ecco-jcc/jjaf103

ECCO Topical Review on Pouch Disorders

J Crohns Colitis. 2025 Jun 17:jjaf103. doi: 10.1093/ecco-jcc/jjaf103. Online ahead of print.

Authors

Affiliations

¹ Icahn School of Medicine at Mount Sinai, Medicine/Gastroenterology, New York, United States.
² Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
³ Department of Surgery, Cantonal Hospital of Fribourg and Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.
⁴ Alfred Health, Gastroenterology, Melbourne, Australia.
⁵ CEMIC University Hospital, Colorectal Surgery, Buenos Aires, Argentina.
⁶ Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
⁷ Radboud University Medical Center, Gastroenterology, Nijmegen, the Netherlands.
⁸ Unidade Local de Saúde Gaia e Espinho, Department of Gastroenterology, Vila Nova de Gaia, Portugal.
⁹ IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
¹⁰ St. Mark's Hospital, IBD Unit, United Kingdom.
¹¹ Cleveland Clinic, Department of Colon & Rectal Surgery, Cleveland, United States.
¹² University Hospital of Ghent, Department of Gastroenterology and Hepatology, Ghent, Belgium.
¹³ Rabin Medical Center, Gastroenterology, Petach Tikva, Israel.
¹⁴ Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
¹⁵ Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.

PMID: 40574702
DOI: 10.1093/ecco-jcc/jjaf103

Abstract

Background: Pouch disorders are common and may present with symptoms of increased stool frequency, urgency, incontinence, pelvic cramping, obstructed defecation, and perianal drainage, which can result in poor sleep, fatigue, and disability. This topical review aims to offer expert consensus practice recommendations for the diagnosis and management of the most common inflammatory, functional, structural, and neoplastic J-pouch disorders.

Methods: A multidisciplinary panel of gastroenterologists and colorectal surgeons performed a systematic review of the relevant literature on pouch disorders and developed current practice positions.

Results: Seventeen current practice positions were developed on the diagnosis and management of inflammatory, functional, structural, and neoplastic pouch disorders.

Conclusions: A multidisciplinary approach is essential for the diagnosis and management of pouch disorders.

Keywords: pouch; pouchitis; proctocolectomy; ulcerative colitis.

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